强迫症的临床特征

Clinical characters of obsessive compulsive disorder

目的 :探讨强迫症 (OCD)的临床表现。 方法 :对 40例符合 DSM- OCD诊断标准病人进行以下量表和问卷评定 :强迫症量表 (Y- BOCS) ,Hamilton抑郁量表 (HAMD) ,Ham ilton焦虑量表 (HAMA ) ,Marks恐怖强迫量表 (MSCPOR) ,临床疗效总评量表 (CGI)和艾森克个性问卷(EPQ) ;并对 6 5名正常人进行 EPQ测试。 结果 :15岁以前发病患者的 MSCPOR的工作适应能力下降 (WD)分显著高于 15岁以后发病患者 ;合病组病人的 HAMD和 EPQ的神经质分显著高于非合病组 ;洗涤 /回避组的 HAMA评分显著较高 ,迟缓 /仪式化组的发病年龄显著较低 ,两组的 MSCPOR的WD评分均显著高于强迫检查行为组。 结论 :15岁以前发病 ,合病组 ,主要表现迟缓 /仪式化或洗涤/回避症状的病人是 OCD较为严重的亚型。

Objective:To explore the clinical features and subtypes of obsessive compulsive disorder (OCD). Method:Forty cases of OCD were assessed with Yale Brown obsessive compulsive scale (Y BOCS),Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),clinical global impression(CGI) and Eysenk personality questionnaire(EPQ),and 65 normal controls were measured with EPQ. Results:The scores of work disability(WD) item of Marks scale for compulsions,phobias,obsessions and rituals(MSCPOR) were significantly higher on patients whose onset age were less than 15.The comorbid group had significantly higher in patients whose onset age were less than 15.The comorbid group had significantlly higher scores of HAMD and neuroticism subscale of EPQ.The scores of HAMA were higher in patients characterized by washing/phobic avoid behavior,and the onset age was younger in patients characterized by slowness/ritual behavior.Both groups had higher scores in work disability item of MSCPOR. Conclusion:It is suggested that slowness/ritual behavior and washing/avoid behavior are severe subtypes of OCD,and the patients with these subtypes usually have comorbidities,whose onset age are less than 15.