强迫障碍共病轴I及其与童年期创伤性经历的关系

Relationship between Childhood Traumatic Experiences and the Comorbidity of Obsessive-Compulsive Disorder and Axis I

目的研究强迫障碍(OCD)共病轴I及其与童年期创伤性经历的关系。方法符合DSM-IV临床诊断标准的44例OCD患者为被试,应用DSM-IV-TR轴I障碍定式临床检查病人版(SCID-I/P)半定试检查OCD患者共病轴心境障碍、焦虑障碍的情况,确定共病轴I障碍患者。用童年期创伤问卷(CTQ-SF)测查OCD患者的童年期创伤性经历。结果有25例OCD患者共病轴I心境障碍和或焦虑障碍。OCD共病轴I障碍除了情感虐待、躯体虐待、情感忽视和躯体忽视外,只有性虐待(Waldχ2=4.036,P<0.05)1个因子进入Logistic回归方程。其中性虐待b=1.813,exp(b)=6.131,exp(b)95%的C.I.为(1.045～35.960),性虐待因子的回归系数(b)>0,比值比(OR)=exp(b)>1。结论 OCD患者童年期的性虐待是OCD共病轴I心境障碍和或焦虑障碍的危险因素。

Objective To explore the relationship between childhood traumatic experiences and the cmorbidity of obsessive-compulsive disorder and Axis I.Methods DSM-IV was administrated to subjects to diagnose OCD patients.SCID-I/P was administrated to 44 OCD patients diagnosed clinically to formally determine whether they met DSM-IV criteria for Axis I mood disorders and anxiety disorders.Childhood traumatic experiences of these OCD patients were measured with Childhood Trauma Questionnaire （CTQ）.Results 25 of 44 OCD patients met DSM-IV criteria for Axis I mood disorders and anxiety disorders.Logistic regression analysis showed that comorbidity of OCD and Axis I disorders could be accounted for sexual abuse.（Wald χ2=4.036,P〈0.05）.sexual abuse b=1.813,exp（b）=6.131,exp（b）95% C.I.（1.045～35.960）.Conclusion Sexual abuse is the risk factor for comorbidity of OCD and Axis I mood disorders and anxiety disorders.