Hantouche E G, Bouhassira M, Lancrenon S, Ravily V, Bourgeois M
Service hospitalo-universitaire de Santé mentale et de Thérapeutique, Hôpital Sainte-Anne, Paris.
Encephale. 1995 Sep-Oct;21(5):571-80.
Recent epidemiologic studies were conducted in general population, showing high rate prevalence of obsessive-compulsive disorder (OCD) (2-3%). Although more investigation of OCD prevalence in clinical population is still warranted. The prevalence of DSM III-R diagnosis of OCD and obsessive-compulsive syndromes (OCS) is reported in 4 364, 16-70 year old new consecutive patients, consulting in out-patient psychiatry. Point prevalence rates of 9.2% were recorded for OCD and 17% for OCS. Significantly different from non obsessional patients, it was observed in OCD and OCS patients more male representation (41% vs 37%, p = 0.007), a younger current age (36 y vs 39 y, p < 10(-4)) and age of disorder onset, higher rate of celibat (31.5% vs 28.6%) and lesser of separated or widowed (9.4% vs 16.2%, p = 0.003), more anxiety and depression comorbidity (50% vs 39%, p < 10(-4), a higher suicidal risk (17% vs 14%, p = 0.04--especially in OCS patients: 18.3%), more chronicity (mean current episode duration: 14.8 months vs 11.2 m., p < 10(-4)) and higher rate of global functioning impairment (score at GAF: 53.9 vs 57.9, p < 10(-4)). The results of the french survey confirmed the high prevalence of OCD and OCS in patients seeking psychiatric treatment. OCS (or subclinical OCD) seem to form a valid group (high rates of comorbidity and suicidal attempts) which need to be recognized and to receive adequate treatment.
近期在普通人群中开展了流行病学研究，结果显示强迫症（OCD）的患病率较高（2%-3%）。尽管仍有必要对临床人群中强迫症的患病率进行更多调查。本文报告了4364名年龄在16至70岁之间、连续就诊的门诊精神科新患者中，DSM III-R诊断的强迫症及强迫综合征（OCS）的患病率。强迫症的时点患病率为9.2%，强迫综合征为17%。与非强迫性患者相比，强迫症和强迫综合征患者存在显著差异，表现为男性比例更高（41%对37%，p = 0.007）、当前年龄更小（36岁对39岁，p < 10⁻⁴）以及发病年龄更小，独身率更高（31.5%对28.6%），分居或丧偶率更低（9.4%对16.2%，p = 0.003），焦虑和抑郁共病率更高（50%对39%，p < 10⁻⁴），自杀风险更高（17%对14%，p = 0.04，尤其是强迫综合征患者：18.3%），病程更长（当前发作的平均持续时间：14.8个月对11.2个月，p < 10⁻⁴），以及整体功能受损率更高（GAF评分：53.9对57.9，p < 10⁻⁴）。法国的这项调查结果证实了在寻求精神治疗的患者中强迫症和强迫综合征的高患病率。强迫综合征（或亚临床强迫症）似乎构成了一个有效的群体（共病率和自杀未遂率较高），需要得到识别并接受适当治疗。
