强迫症患者生活质量状况及其影响因素

Influencing factors of quality of life in patients with Obsessive - compulsive disorder

目的调查强迫症患者的生活质量及其影响因素。方法采用世界卫生组织生活质量评定量表简表(WHOQOL-BREF)调查78例门诊强迫症患者(病例组)及60例正常对照组的生活质量,同时采用耶鲁-布朗强迫量表(Y-BOCS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评定患者强迫、抑郁及焦虑症状。结果病例组WHOQOL-BREF量表的生理领域、心理领域、社会关系领域、环境领域得分[分别为(64.70±10.30)分,(47.60±11.50)分,(53.10±12.20)分,(63.70±10.60)分]均低于正常对照组[分别为(79.20±9.60)分,(71.20±10.40)分,(74.10±9.80)分,(75.10±10.30)分],差异有统计学意义(t=-12.50^-6.30,P均<0.01)。Y-BOCS总分、强迫观念总分、HAMD总分均与WHOQOL-BREF所有领域得分负相关(r=-0.28^-0.61,P<0.05);强迫行为总分仅与生理领域得分负相关(r=-0.49,P<0.01)。多元回归分析显示,强迫行为、HAMD总评分和HAMA总评分进入"生理领域"回归方程;在"心理领域"回归方程中除HAMA总评分外其余自变量均进入方程;强迫观念总评分、强迫行为总评分及HAMD总分进入"社会领域"回归方程;强迫观念总评分和HAMD总分进入"环境领域"回归方程。结论强迫症患者生活质量低于正常人群;强迫观念、强迫行为、伴发的抑郁症状是强迫症患者生活质量的重要影响因素。

Objective To investigate the quality of life in patients with Obsessive -compulsive disorder（ OCD）, and to explore the influencing factors. Methods The WHOQOL - BREF was administered to 78 outpatients with OCD and 60 normal controls, and their scores were compared. Symptom severity was assessed with the Yale - Brown Obsessive - Compulsive Scale （ Y - BOCS）, HAMA and HAMD were also administered to. Results Compared to normal controls, patients with OCD showed signifi- cant impairments in all domains of quality of life （P 〈 0. 01 ）. Y - BOCS total score, Y - BOCS obsessions sub - score, HAMD score were significantly correlated with all of WHOQOL - BREF subscales score （ r = - 0.28 ～ - 0.6l, P 〈 0.05 ）. Y - BOCS compulsions subscore were only correlated with WHOQOL- BREF Physical well -being sub -score（ r = -0. 49, P 〈 0.01 ）. Severity of obsessions, compulsions and depressive symptoms were significant predictors of impairment of quality of life in patients with OCD. Conclusion All aspects of quality of life are markedly affected in individuals with OCD and are associated with OCD severity （particularly obsession severity） and depression severity .