强迫症与人格障碍共病状况研究

Comorbidity of obsesseive-compulsive with personality disorder

目的以人格障碍定式检测工具对强迫症患者进行评估 ,以探索强迫症与人格障碍的共病状况以及人格障碍对强迫症的临床影响。方法采用CCMD 2 R人格障碍筛查问卷 (PDQC)、CCMD 2 R人格障碍定式检测手册 (SCICP)对 99例强迫症患者进行检测 ,据其是否符合人格障碍诊断而分为两个组别 ,即共病组 (OCD +PD) ;非共病组 (OCD)。分析比较功能大体评定量表 (GAFS)、焦虑状态 特质问卷 (STAI)和症状自评量表 (SCL 90 )得分和强迫症状在两组间的差异。结果 5 6例强迫症被试 ( 5 6.6% )至少符合一个类别人格障碍诊断 ;共病组的在婚率、全日制工作比率和功能大体评定量表 (GAFS)总均分较非共病组低 ;共病组发病年龄较非共病组小 ;共病组病程较非共病组长 ;共病组受教育年限较非共病组短 ;共病组病前突发生活事件发生率、焦虑特质分量表得分、SCL 90总均分以及人际关系敏感、抑郁、焦虑、敌意、偏执各分量表得分均显著高于非共病组。结论人格障碍临床定式检测结果显示 ,强迫症与人格障碍的共病率高达 5 0 %以上 ;人格障碍对强迫症患者病理心理的严重程度、社会适应能力、临床治疗和预后有着不可忽视的影响。

ObjectiveTo investigate patterns of personality disorder (PD) comorbidity in patient with obsesseive-compulsive(OBC) and the influence of PD comorbidity on the patient with OCD. Methods 99 patients with obsessive-compulsive were assessed by Structured Clinical In terview for CCMD-2-R personality disorder (SCICP),Personality Disorder Questionnaire for CCMD-2-R personality disorder(PDQ),Global Assessment of Functioning Scale(GAFS), The State-Trait Anxiety Inventory (STAI) and SCL-90. Chi-square and t-test were used in data analysis. Results 56.6% of patients with OCD meet the criteria for at least one PD. Among comorbid PD the anxious-fearful( Cluster C)PSs were most prevalent, followed by the odd-eccentric(Cluster A)PDs, The patients with PD had more severe social maladaptation , concurrent depressive,anxious,interpersonal relationships sensitive, hostility , paranoid symptoms and longer duration of illness ,earlier age at onset than the patients without any PD despite the similar severity of OCD symptoms. Conclusion The prevalence of PD assessed using the structured interview methods is a considerably high(more than 50%) among the patients with OCD in the study.The comorbidity with PD in OCD was related to more severe social ,occupational or interpersonal problems, more worse therapy effect and prognosis because of having a greater degree of psychopathology.