亚临床强迫症与首发强迫症患者抑制功能比较

Inhibitory control comparison between patients with subclinical obsessive-compulsive disorder （OCD） and with first-episode OCD

目的比较亚临床强迫症、首发强迫症患者与正常对照抑制功能的差异。方法采用连线测验（TMT）、Stroop测验、威斯康星卡片分类测验（WCST）评估35例亚临床强迫症和35例首发强迫症患者，以及年龄和教育程度匹配的35例正常对照。结果（1）与正常对照比较，亚临床强迫组wCST测验中WCST完成分类数、WCST正确数，Stroop测验中读字色（Stroop-CW）的正确数，TMT测验中TMT-B完成时间测验成绩明显低于正常对照组，差异有统计学意义（P〈0．05），与强迫症患者组比较差异无统计学意义（P〉0．05）；与正常对照比较，强迫症患者组Stroop测验中Stroop-CW错误数、TMT测验中TMT-A完成时间成绩明显差于正常组，差异具有统计学意义（P〈0．05），与亚临床强迫症组比较差异有统计学意义（P〈0．01）；（2）相关分析显示，强迫症组患者组的病程与TMT-B完成时间呈正相关（r=0．277，P=0．004）。结论亚临床强迫症和首发强迫症患者存在抑制功能受损，执行功能损害在强迫症发生发展中起着重要作用。

Objective We investigated the neuropsychological pro？ le of subjects in a subclinical obsessive-compulsive disorder （OCD） sample, first-episode OCD and normal control. Methods Subjects with subclinical obsessive-compulsive （n=35）, patients in their first episode of OCD （n =5） and normal comparison subjects （n= 35） were assessed on a neurocognitive battery. All subjects finished a series of neuropsychological tests,including the Wisconsin card sorting test（WCST）, trail-making test （TMT） and stroop color word interference test （Stroop）. Results （1） The subclinical OCD group showed poorer performances on the total correct responses of WCST, number of categories correct of WCST, total number of correct responses of Stroop-CW, and completion times of TMT-B compared with the normal group （P 〈 0.05 or P〈0.01）. However, there was no difference of these assessments between sub-clinical OCD group and first-episode OCD group. In addition, the OCD group showed higher rates of total errors on Stroop-CW, and longer completion time in TMT-A compared with the subclinical OCD group and the normal group. （2） Correlation analysis showed that the disease duration in OCD group was positively correlated with completion time in TMT-B （r=0. 277, P = 0. 004）. Conclusions These results suggest that both subclinical OCD and patients with OCD seemed to display deficits in inhibitory control. Moreover, executive dysfunction may serve as the pathological mechanism un- derlying the development of obsessive-compulsive disorder.