喹硫平合并5-羟色胺再摄取抑制剂对难治性强迫症疗效及认知功能的影响

Effects of quetiapine-augmentation on clinical symptom and cognitive functioning in obsessive-compulsivedisorder

目的观察喹硫平合并5-羟色胺再摄取抑制剂治疗难治性强迫症的疗效及对认知功能的影响。方法58名难治性强迫症患者，随机分为喹硫平合并治疗组（n=29）和安慰剂合并治疗组（n=29）。在基线和治疗8周结束时进行Yale-Brown量表和认知功能评定，认知功能评定包括威斯康星卡片分类测验，Stroop测验，持续操作试验，韦氏记忆量表，以评估患者的注意、记忆和执行功能。比较2组治疗前后Yale-Brown量表和认知功能评分。结果喹硫平合并治疗组和安慰剂组治疗前Yale-Brown量表总分分别为（28．5±4．4）分，（26．3±6．5）分；治疗后分别为（18．5±6．4）分，（25．7±5．4）分，差异有显著性（P=0．01）。治疗前后威斯康星卡片分类测验中维持不能数增加，治疗前分别为（1．2±1．1）分，（1．3±1．4）分；治疗后分别为（1．6±1．0）分，（1．5±1．2）分，差异有显著性（P=0．03），其余认知功能测验指标治疗前后差异无显著性。结论喹硫平合并治疗对难治性强迫症有效，对认知功能无明显影响。

Objective To investigate the efficacy and effects on cognitive functioning of antipsychotic ad- dition to serotonin reuptake inhibitors in patients with treatment-refractory obsessive-compulsive disorder. Methods 58 therapy-resistant OCD patients were randomly grouped and receipt 8-week quetiapine-augmentation treatment or placebo respectively. At baseline and post-treatment, in order to evaluate symptom, executive functions, attention and memory, all patients were measured with Yale-Brown Obsessive-Compulsive Scale and cognitive functioning test, which included Wisconsin Card Sorting Test, Stroop Color Word Test, Continuous Performance Test and Memory Scale. Results Comparing quetiapine-augmentation group and placebo, there was significant difference of Y-BOCS total score between baseline and post-treatment （ baseline ： 28.5 ± 4.4,26.3 ± 6.5, post-treatment ： 18.5 ± 6.4,25.7 ± 5.4, respectively, P = 0.01 ）. There was no major effects on cognitive functioning, apart from a failure to maintain set on the WCST （ baseline： 1.2 ± 1.1,1.3 ± 1.4,post-treatment： 1.6 ± 1.0,1.5 ± 1.2, respectively, P = 0.03 ）. Conclusion It was effective of quetiapine-augmentation treatment on refractory OCD. There was no major effects on cognitive functioning of quetiapine-augmentation treatment.