Awasthi Snigdha, Satapthy Ramananda
Dept. of Psychiatry, Manipal Tata Medical College, Baridih, Jamshedpur, Jharkhand, India.
Government Hospital for Mental Care, Pedda Waltair, Visakhapatnam, Andhra Pradesh, India.
Indian J Psychol Med. 2023 Jul;45(4):383-389. doi: 10.1177/02537176231174063. Epub 2023 Jun 26.
Early psychiatrists inferred that obsessive-compulsive symptoms (OCS) represent a defense against psychosis and prevent the progression of schizophrenia. However, recent clinical research has yielded inconsistent results across studies regarding the link between OCS and the symptom domains of schizophrenia and the influence OCS have on a patient's functioning and quality of life (QOL).This study aimed to determine whether OCS has any association with the symptom severity, functioning, and QOL of schizophrenia patients.
This cross-sectional study done in a tertiary care hospital consecutively recruited 85 outpatients of schizophrenia in clinical remission over one year. Positive and Negative Syndrome Scale (PANSS), Yale-Brown Obsessive Compulsive Scale (Y-BOCS), WHO Quality of Life Brief Version (WHO QOL-BREF), and Global Assessment of Functioning (GAF) scales were applied.
Eighteen patients (21.2%) had OCS (Y-BOCS score of ≥8). Patients with OCS had higher PANSS scores (mean±SD of total score 77.16± 16.4, P < 0.001), suggestive of more severe psychosis, poor functioning overall (mean GAF score 37.35 ± 15.62, P < 0.001), and poor QOL in the psychological domain (P < 0.001). In addition, significant associations were present between the Y-BOCS score and the PANSS ( = 0.65), GAF ( = -0.61), and WHO QOL BREF scores in the physical ( = -0.39), and psychological domains ( = -0.41) (P < 0.001 on all of the above).
Patients with OCS have more severe symptoms and a lower QOL. A significant association exists between the intensity of OCS and schizophrenia symptoms, global functioning, and QOL.
早期精神科医生推断,强迫症状(OCS)是对精神病的一种防御,并可防止精神分裂症的进展。然而,近期的临床研究在关于OCS与精神分裂症症状领域之间的联系以及OCS对患者功能和生活质量(QOL)的影响方面,各项研究结果并不一致。本研究旨在确定OCS是否与精神分裂症患者的症状严重程度、功能及生活质量存在关联。
这项横断面研究在一家三级护理医院进行,连续招募了85名处于临床缓解状态超过一年的精神分裂症门诊患者。应用了阳性与阴性症状量表(PANSS)、耶鲁-布朗强迫量表(Y-BOCS)、世界卫生组织生活质量简表(WHO QOL-BREF)以及总体功能评定量表(GAF)。
18名患者(21.2%)存在OCS(Y-BOCS评分≥8)。有OCS的患者PANSS总分更高(均值±标准差为77.16±16.4,P<0.001),提示精神病性症状更严重,整体功能较差(平均GAF评分为37.35±15.62,P<0.001),且心理领域的生活质量较差(P<0.001)。此外,Y-BOCS评分与PANSS(r = 0.65)、GAF(r = -0.61)以及WHO QOL BREF身体领域(r = -0.39)和心理领域(r = -0.41)评分之间存在显著相关性(上述各项P均<0.001)。
有OCS的患者症状更严重,生活质量更低。OCS的强度与精神分裂症症状、整体功能及生活质量之间存在显著关联。