Hantouche E G, Bourgeois M, Bouhassira M, Lancrenon S
Service Hospitalo-Universitaire de Santé Mentale et de Thérapeutique, Hôpital Sainte-Anne, Paris.
Encephale. 1996 Jul-Aug;22(4):255-63.
Obsessive-Compulsive Disorder (OCD) had received a new interest from fundamental research (psychopharmacology, neurobiology and brain imagery...). Although more investigation of OCD clinical aspects are needed, especially in large cohorts of patients, not seen nor investigated only in high specialized psychiatric units. A large french survey "Screening-Understanding-Treating OCD" was conducted in 1994 with the participation of 240 psychiatrists. The survey had included 4,363 new consecutive patients consulting in out-patient psychiatry. The phase 1 had shown a point prevalence rates of 9.2% for OCD (full criteria of DSM III-R) and 17% for OCS (Obsessive-Compulsive Syndromes). From 731 patients, the phrase 2 was conducted on a cohort of 646 patients with OCD or OCS and had explored in details in the clinical aspects of the OC illness (typology, symptomatic categories, comorbidity, OCD spectrum, psychiatric family history and treatment history...). The results of the french survey phase 2 had confirmed a variety of classical and current literature data, especially: the ICD 10 proposal for diagnostic sub-typology according to symptomatic predominance (obsessions, compulsions or both); the symptomatic clustering of obsessions and compulsions into three major categories, suggested by a recent study from the Boston University; the high rate of comorbidity with anxiety and depressive disorders and with disorders related to the large OCD spectrum (somatoform disorders, eating disorders, impulse-control disorders, compulsive buying...); the impact of clinical parameters (as slowness, avoidance, lack of insight) on clinical global OCD and OCS severity; the high rate of intrafamilial psychiatric morbidity (OCD, depression, anxiety disorders).
强迫症（OCD）已引起基础研究（心理药理学、神经生物学和脑成像等）的新关注。尽管对强迫症临床方面还需要更多研究，尤其是在大量患者群体中，而不仅是在高度专业化的精神科病房中观察和研究。1994年法国开展了一项大型调查“筛查 - 理解 - 治疗强迫症”，有240名精神科医生参与。该调查纳入了4363名连续前来门诊精神科就诊的新患者。第一阶段显示强迫症（符合DSM III - R全部标准）的时点患病率为9.2%，强迫综合征（OCS）为17%。在731名患者中，第二阶段针对646名患有强迫症或强迫综合征的患者群体进行，详细探讨了强迫障碍疾病的临床方面（类型学、症状类别、共病、强迫症谱系、精神科家族史和治疗史等）。法国调查第二阶段的结果证实了各种经典和当前文献数据，特别是：根据症状优势（强迫观念、强迫行为或两者皆有），ICD 10提出的诊断亚类型；波士顿大学最近一项研究提出的强迫观念和强迫行为症状聚类为三大类；与焦虑和抑郁障碍以及与大强迫症谱系相关疾病（躯体形式障碍、进食障碍、冲动控制障碍、强迫性购物等）的高共病率；临床参数（如迟缓、回避、缺乏洞察力）对强迫症和强迫综合征临床总体严重程度的影响；家族内精神疾病发病率高（强迫症抑郁、焦虑障碍）。
