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共病强迫症与注意力缺陷多动障碍患者的强迫观念及临床特征

Obsessive Beliefs and Clinical Features in Patients with Comorbid Obsessive-Compulsive Disorder and Attention-Deficit/Hyperactivity Disorder.

作者信息

Yücens Bengü, Kart Ayşegül, Tümkaya Selim

机构信息

Department of Psychiatry, Pamukkale University School of Medicine, Denizli, Turkey.

Department of Psychiatry, Bakirkoy Mental and Nervous Diseases Training and Research Hospital, Istanbul, Turkey.

出版信息

Psychiatry Clin Psychopharmacol. 2021 Dec 1;31(4):408-416. doi: 10.5152/pcp.2021.21200. eCollection 2021 Dec.

Abstract

BACKGROUND

Obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) are two common neuropsychiatric conditions. Obsessive beliefs, comprising the importance and control of intrusive thoughts, inflated sense of responsibility for harm, overestimations of threat, perfectionism, and intolerance of uncertainty have been suggested to influence OCD symptomatology. Although OCD patients with ADHD have been reported to have different clinical characteristics compared to patients with OCD without ADHD, it has not been previously investigated whether OCD patients with and without ADHD differ in terms of obsessive beliefs. The aim of this study was to compare the obsessive beliefs and obsessive-compulsive symptoms of OCD patients with and without ADHD.

METHODS

The study included a total of 197 OCD patients who were assessed with the sociodemographic data form, Wender Utah Rating Scale, Turgay's Adult ADD/ADHD Diagnosis and Evaluation Scale, The Adult ADHD Self-Report Scale, Obsessive Beliefs Questionnaire-44 (OBQ-44), Yale-Brown Obsessions and Compulsions Scale, Dimensional Obsessive-Compulsive Scale (DOCS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI).

RESULTS

The scores of all subscales of OBQ-44, the responsibility, unacceptable thoughts, and symmetry subscales of DOCS, BDI, and BAI scores were higher in the OCD with ADHD group than in the OCD only group. The results showed that when depression and anxiety were controlled, "the importance and control of intrusive thoughts" domain of obsessive beliefs was the unique predictor of OCD and ADHD comorbidity.

CONCLUSION

These findings provide a better understanding of cognitive features in OCD patients with ADHD.

摘要

背景

强迫症(OCD)和注意力缺陷多动障碍(ADHD)是两种常见的神经精神疾病。有人提出,强迫观念包括对侵入性思维的重视和控制、对伤害的过度责任感、对威胁的高估、完美主义以及对不确定性的不容忍,会影响强迫症的症状表现。尽管有报道称,患有ADHD的OCD患者与未患ADHD的OCD患者具有不同的临床特征,但此前尚未研究过患有和未患ADHD的OCD患者在强迫观念方面是否存在差异。本研究的目的是比较患有和未患ADHD的OCD患者的强迫观念和强迫症状。

方法

该研究共纳入197名OCD患者,使用社会人口统计学数据表、温德尔犹他评定量表、图尔盖成人注意力缺陷多动障碍诊断与评估量表、成人ADHD自陈量表、强迫信念问卷-44(OBQ-44)、耶鲁-布朗强迫观念与强迫行为量表、维度强迫量表(DOCS)、贝克抑郁量表(BDI)和贝克焦虑量表(BAI)对其进行评估。

结果

ADHD合并OCD组的OBQ-44所有子量表得分、DOCS的责任、不可接受的想法和对称性子量表得分、BDI和BAI得分均高于单纯OCD组。结果表明,在控制抑郁和焦虑后,强迫观念的“侵入性思维的重要性和控制”领域是OCD与ADHD共病的唯一预测因素。

结论

这些发现有助于更好地理解患有ADHD的OCD患者的认知特征。

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