强迫障碍及其与人格障碍共病患者的童年期被虐待经历

Childhood Maltreatment Experiences of Patients with both Obsessive-Compulsive Disorder and Personality Disorders

目的:研究强迫障碍(OCD)与人格障碍共病患者的童年期被虐待经历。方法:符合DSM-IV临床诊断标准的OCD患者,应用DSM-IV-TR轴I障碍定式临床检查病人版(SCID-I/P)做定式检查,最终确诊44例患者为被试,用PDQ+4在OCD患者中筛查,再用(PDI-IV)做半定式查询确定人格障碍患者,用童年期创伤问卷(CTQ-SF)施测。另招募正常对照50例施测CTQ-SF。结果:OCD患者除躯体虐待外,情感虐待、性虐待、躯体忽视、情感忽视和总分均显著高于正常对照组(P<0.01)。除躯体虐待外,伴有人格障碍组的CTQ-SF各因子和总分均显著高于对照组(55.50/32.54,49.63/36.30,55.84/32.32,51.03/34.76,52.72/34.32,P<0.01)。不伴有人格障碍组则只有情感忽视显著高于对照组(42.50/28.25,P<0.05)。结论:OCD与人格障碍共病患者的童年期创伤性经历较正常对照组严重,提示共病人格障碍的OCD患者童年期遭遇过较多的情感虐待、性虐待、情感忽视和躯体忽视,而“纯粹OCD”患者则受到较多的情感忽视。

Objective： To explore childhood traumatic experiences of OCD patients who were also diagnosed personality disorders （ PDs） and those without PDs. Methods： SCID-I/P was administrated to diagnose OCD patients. PDQ^ ＋4 and PDI-IV were then administrated to 44 OCD subjects to determine whether they also suffered from personality disorders. Childhood maltreatment experiences of the sample were measured with Childhood Trauma Questionnaire （ CTQ） . 50 normal control were also collected and subjected to CTQ - SF tests. Results： 32 of 44 （72% ） OCD patients also met DSM-IV criteria for personality disorders. OCD patients scored significantly higher than normal control in CTQ-SF （Childhood Truma Questianuaire -28 Short Form） and in all domains with the exception of physical abuse. Comparison between OCD subjects with PDs and normal control, the former scored significantly higher in emotional a- buse （55. 10/32. 54）, sex abuse （49.63/36. 30）, physical neglect （52. 03/34. 76）, and emotional neglect domains （ 55.84/32. 32 ） . Whereas OCD subjects without PDs only scored significantly higher in emotional neglect domains compared with normal control （ 42. 50/28.26 ） . Conclusions： Subjects with PDs experienced more severe traumatic events during their early life. ＂ pure OCD＂ patients, however, might experienced more emotional neglect.