Grootendorst-van Mil Nina, Chang Chin-Kuo, Chandran David, Schirmbeck Frederike, van Beveren Nico, Shetty Hitesh, Stewart Robert, Ahn-Robbins Deborah, de Haan Lieuwe, Hayes Richard D
Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Antes Center for Mental Health Care, Rotterdam, The Netherlands.
Acta Neuropsychiatr. 2024 Oct 10;37:e45. doi: 10.1017/neu.2024.42.
To assess the psychosocial functioning concerning obsessive-compulsive symptoms (OCS) and/or obsessive-compulsive disorder (OCD) comorbidity in people with schizophrenia, schizoaffective disorder, or bipolar disorder diagnosed in a large case register database in Southeast London. Data were retrieved from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) register using Clinical Record Interactive Search (CRIS) system, a platform allowing research on full but de-identified electronic health records for secondary and tertiary mental healthcare services. Information of schizophrenia, schizoaffective disorder, bipolar disorder diagnosis and OCS/OCD status was ascertained from structural or free-text fields through natural language processing (NLP) algorithms based on artificial intelligence techniques during the observation window of January 2007 to December 2016. Associations between comorbid OCS/OCD and recorded Health of the Nation Outcome Scales (HoNOS) for problems with activities of daily living (ADLs), living conditions, occupational and recreational activities, and relationships were estimated by logistic regression with socio-demographic confounders controlled. Of 15,412 subjects diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder, 2,358 (15.3%) experienced OCS without OCD, and 2,586 (16.8%) had OCD recorded. The presence of OCS/OCD was associated with more problems with relationships (adj.OR = 1.34, 95% CI: 1.25-1.44), ADLs (adj.OR = 1.31, 95%CI: 1.22-1.41), and living conditions (adj.OR = 1.31, 95% CI: 1.22-1.41). Sensitivity analysis revealed similar outcomes. Comorbid OCS/OCD was associated with poorer psychosocial functioning in people with schizophrenia, schizoaffective disorder, or bipolar disorder. This finding highlights the importance of identification and treatment of comorbid OCS among this vulnerable patient group.
为评估伦敦东南部一个大型病例登记数据库中诊断为精神分裂症、分裂情感性障碍或双相情感障碍的患者中，强迫症状（OCS）和/或强迫症（OCD）共病的心理社会功能状况。数据是使用临床记录交互式搜索（CRIS）系统从南伦敦和莫兹利国民保健服务基金会信托生物医学研究中心（SLaM BRC）登记处检索的，该平台允许对二级和三级精神卫生保健服务的完整但匿名的电子健康记录进行研究。在2007年1月至2016年12月的观察期内，通过基于人工智能技术的自然语言处理（NLP）算法，从结构化或自由文本字段中确定精神分裂症、分裂情感性障碍、双相情感障碍诊断以及OCS/OCD状态的信息。在控制了社会人口学混杂因素的情况下，通过逻辑回归估计共病OCS/OCD与记录的国民健康结果量表（HoNOS）中关于日常生活活动（ADL）、生活条件、职业和娱乐活动以及人际关系问题之间的关联。在15412名被诊断为精神分裂症、分裂情感性障碍或双相情感障碍的受试者中，2358名（15.3%）出现了无强迫症的强迫症状，2586名（16.8%）记录有强迫症。OCS/OCD的存在与人际关系（调整后比值比=1.34，95%置信区间：1.25-1.44）、ADL（调整后比值比=1.31，95%置信区间：1.22-1.41）和生活条件（调整后比值比=1.31，95%置信区间：1.22-1.41）方面的更多问题相关。敏感性分析显示了相似的结果。共病OCS/OCD与精神分裂症、分裂情感性障碍或双相情感障碍患者较差的心理社会功能相关。这一发现凸显了在这一脆弱患者群体中识别和治疗共病OCS的重要性。
