强迫障碍患者短期预后的随访研究

The follow-up study of short-term prognosis in patients with obsessive-compulsive disorder

目的：观察强迫障碍患者短期预后。方法：对就诊后6-31个月的57例强迫障碍患者进行电话随访，并进行耶鲁-布朗强迫量表（Y-BOCS）、社会功能缺陷筛选量表（SDSS）及主观幸福感评估。结果：随访时57例患者的诊断未有改变，继续药物治疗和/或心理治疗36例（63.2％）；Y-BOCS 及SDSS 评分较初诊（基线）时显著下降（P 均﹤0.01）；病情为轻度~中度比例（78.9％，45例）较初诊时（15.8％，9例）明显提高，重~极重度比例（21.1％，12例）较初诊时（86.0％，48例）明显下降（P 均﹤0.01）；社会功能良好、较好、较差的比率分别为43.9％（25例）、43.9％（25例）及12.3％（7例），与初诊时（5.3％，38.6％，56.1％）比较差异有统计学意义（P ＝0.000）。主观幸福度感评分（6.07±2.5）分，与中国常模[（6.94±1.61）分]相近；影响社会功能的因素是 Y-BOCS 评分（r ＝0.750，P ﹤0.01）。结论：接受治疗的强迫障碍患者短期预后良好，病情是影响患者社会功能的因素。

To observe the short-term prognosis in patients with obsessive-compulsive disorder （OCD）. Method：Fifty-seven OCD patients were telephone follow-up after 6 to 31 months treatment. In the follow-up,the patients were assessed by Yale-Brown obsessive compulsive scale（Y-BOCS）,social function defect screening scale（SDSS）and subjective well-being scale. Results：During the follow-up,the diagnosis of all the cases was not changed. Thirty-six cases（63. 2% ）continued the medication and/ or psychotherapy. The scores of Y-BOCS and SDSS were significantly decreased than those in baseline（all P ﹤0. 01）. Compared with the first visit （baseline）,the ratio of patients’condition from mild to moderate（78. 9% ,45 cases vs. 15. 8% ,9 cases）was obvi-ously increased,from severe to very severe was significantly decreased（21. 1% ,12 cases vs. 86. 0% ,48 cases） （all P ﹤0. 01）. The ratios of social function well,better,worse were 43. 9%（25 cases）,43. 9%（25 cases）and 12. 3%（7 cases）respectively,and significantly different than baseline（5. 3% ,38. 6% ,56. 1% ;P = 0. 000）. The score of subjective well-being was（6. 07 ±2. 5）and closed to Chinese normal（6. 94 ±1. 61）. The influencing factors of social function was the score of Y-BOCS（r =0. 750,P ﹤0. 01）. Conclusion：The short-term prognosis of OCD patients receved treatment is good. The influencing factors of social function is the state of illness.