强迫症患者心理社会功能的多维受损及其影响因素的初步分析

A preliminary analysis of multi-dimensional impairment of psychosocial functioning in patients with obsessive-compulsive disorder and its influencing factors

目的:探索强迫症(OCD)患者心理社会功能的损伤及影响因素。方法:研究纳入2021年4月至2022年6月在南京脑科医院门诊就诊的OCD患者153例,使用耶鲁布朗强迫量表(Y-BOCS)评估强迫症严重程度,强迫症症状分类量表修订版(OCI-R)、贝克焦虑量表(BAI)、贝克抑郁量表(BDI-Ⅱ)、席汉残疾量表(SDS)、心理社会功能问卷评估强迫维度、情绪状态和心理社会功能;采用独立样本t检验、相关分析、多元回归分析探索心理社会功能的影响因素。结果:强迫症患者Y-BOCS、OCI-R强迫思维维度、BAI、BDI-Ⅱ、SDS与心理社会功能存在正相关(r=0.381、0.276、0.221、0.549、0.417,P均<0.05)。多元回归结果显示心理社会功能总分受强迫行为和BDI-Ⅱ影响显著(β=0.151、0.492,P均<0.05);主观幸福感受BDI-Ⅱ和SDS工作/学习维度影响显著(β=0.365、0.225,P均<0.05);心理认知受BDI-Ⅱ影响显著(β=0.510,P<0.05);社会功能受BDI-Ⅱ影响显著(β=0.478,P<0.05)。结论:不同临床特征下强迫症患者的心理社会功能损害不同,抑郁症状是心理社会功能的重要影响因素。

Objective:To explore the impairment and influencing factors of psychosocial functioning in patients with obsessive-compulsive disorder(OCD).Method:A cross-sectional study was conducted in 153 OCD patients who visited the outpatient clinic of Brain Hospital Affiliated to Nanjing Medical University from April 2021 to June 2022.The severity of OCD was assessed using the Yale-Brown obsessive compulsive Scale(Y-BOCS),obsessive-compulsive inventory-revised(OCI-R),Beck anxiety inventory(BAI),Beck depression inventory-Ⅱ(BDI-Ⅱ),Sheehan disability scale(SDS),and psychosocial functioning questionnaire were used to assess obsessive-compulsive dimension,mood,and psychosocial functioning.Independent-samples T-test and correlation analysis were used to explore the influencing factors of psychosocial functioning,and then the difference factors were included in multiple regression analysis for further discussion.Results:The score of Y-BOCS,BAI,BDI-Ⅱand SDS were positively correlated with psychosocial functioning(r=0.381,0.276,0.221,0.549,0.417,all P<0.05).Multiple regression analysis showed that the total score of psychosocial functioning was significantly affected by compulsive behavior and BDI(β=0.151,0.492,all P<0.05).Subjective well-being was significantly affected by BDI-Ⅱand work/study dimension(SDS)(β=0.365,0.225,all P<0.05).The psychological cognitive dimension was significantly affected by BDI-Ⅱ(β=0.510,P<0.05).The social functioning dimension was significantly affected by BDI-Ⅱ(β=0.478,P<0.05).Conclusion:OCD patients with different clinical characteristics have different psychosocial functioning impairment,and depressive symptoms are an important influencing factor of psychosocial functioning.