失眠作为接受集中暴露治疗的强迫症青少年治疗结果的预测指标。
Insomnia as a predictor of treatment outcomes in adolescents receiving concentrated exposure treatment for OCD.
机构信息
Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway.
Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway.
出版信息
BMC Psychiatry. 2024 Oct 18;24(1):702. doi: 10.1186/s12888-024-06183-3.
BACKGROUND
Research suggests that individuals with obsessive-compulsive disorder (OCD) frequently experience insomnia. Some previous studies have suggested that insomnia may predict treatment outcomes, but the evidence is limited, especially for adolescents. This study examined the prevalence of insomnia in an adolescent OCD patient sample, explored the correlation between OCD and insomnia, and tested whether levels of insomnia at baseline predict outcomes for adolescent patients receiving the Bergen 4-Day Treatment (B4DT) for OCD.
METHODS
Forty-three adolescent OCD patients who received B4DT were selected for this study. Treatment outcome was quantified as change in Children Yale-Brown Obsessive Compulsive Scale (CY-BOCS) scores across time from pre- to posttreatment and 3-month follow-up. Insomnia symptoms were measured by the Bergen Insomnia Scale (BIS). Linear mixed models were used to examine the relationship between the BIS and changes in CY-BOCS scores. We controlled for symptoms of general anxiety disorder measured by the GAD-7 and depression symptoms measured by the PHQ-9.
RESULTS
In this sample, 68.4% of the patients scored above the cutoff for insomnia on the BIS. There was a moderate correlation between baseline CY-BOCS and BIS that did not reach statistical significance (r = .32, p = .051). High BIS scores before treatment were significantly associated with poorer treatment outcomes, as measured by changes in CY-BOCS over time (p = .002). The association between baseline insomnia and change in OCD symptoms remained significant (p = .033) while controlling for GAD-7 and PHQ-9.
CONCLUSION
Insomnia is common among adolescents with OCD, and these data suggest that these patients may be at increased risk for poor treatment outcomes. Future research to explore mechanisms and adjunctive treatments is warranted.
TRIAL REGISTRATION
The study was approved by the Regional Committee for Medical and Health Research Ethics of Northern Norway (REK Nord: 2023/606482).
背景
研究表明，强迫症（OCD）患者经常会出现失眠。一些先前的研究表明，失眠可能预示着治疗效果，但证据有限，尤其是针对青少年。本研究调查了青少年 OCD 患者样本中失眠的患病率，探讨了 OCD 与失眠之间的相关性，并测试了基线时的失眠程度是否可以预测接受 Bergen 4 天治疗（B4DT）的青少年 OCD 患者的治疗结果。
方法
本研究选择了 43 名接受 B4DT 的青少年 OCD 患者。治疗效果通过儿童耶鲁-布朗强迫症量表（CY-BOCS）评分从治疗前到治疗后和 3 个月随访的变化来量化。失眠症状通过 Bergen 失眠量表（BIS）来测量。线性混合模型用于检验 BIS 与 CY-BOCS 评分变化之间的关系。我们控制了由 GAD-7 测量的一般焦虑障碍症状和由 PHQ-9 测量的抑郁症状。
结果
在这个样本中，有 68.4%的患者 BIS 评分高于失眠的临界值。基线时 CY-BOCS 与 BIS 之间存在中度相关性，但未达到统计学意义（r = .32，p = .051）。治疗前 BIS 评分较高与 CY-BOCS 随时间的变化（p = .002）较差的治疗效果显著相关。在控制 GAD-7 和 PHQ-9 后，基线失眠与 OCD 症状变化之间的关联仍然显著（p = .033）。
结论
失眠在青少年 OCD 患者中很常见，这些数据表明，这些患者可能面临治疗效果不佳的风险增加。未来需要进一步研究以探索机制和辅助治疗。
试验注册
该研究获得了挪威北部地区医学和健康研究伦理委员会（REK Nord：2023/606482）的批准。
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