中重度强迫症患者强迫信念与强迫症状相关分析

The relationship of obsessive beliefs and symptoms in obsessive compulsive disorder patients with moderately and severe level

目的 了解中重度强迫症患者的强迫信念情况及其与强迫症状的关系.方法 采用强迫信念问卷分别对100例强迫症患者（强迫症组）和105名健康对照者（对照组）进行评估,采用耶鲁-布朗强迫症状量表评估强迫症患者的症状严重程度.采用Pearson积差相关分析对强迫信念与强迫症状严重程度进行相关分析.结果 强迫症组在责任感/威胁评估（responsibility/threat estimate,RT）、完美主义/确定性（perfictionism/certainty,PC）、重要性/控制思维（importance/control of thoughts,ICT）和强迫信念总分（Obsessional Beliefs Questionnaire Total score,OBQ-T）得分高于对照组（t=4.82、3.84、3.55、4.64,均P＜0.01）.女性患者强迫行为[（12.5±4.2）分与（9.9±3.8）分]和强迫症状总分[（26.7±5.3）分与（23.5±4.9）分]高于男性患者（t=-3.29、-3.10,均P＜0.01）.强迫信念总分与首次发病年龄、病程、强迫思维、强迫行为和强迫症状总分呈正相关（r=0.40、0.23、0.46、0.42、0.48,均P＜0.01）.ICT与强迫思维和强迫症状总分呈正相关（r=0.21、0.20,均P＜0.05）.ICT进入强迫思维和强迫症状总分回归方程中（β3=0.21、0.07,均P＜0.05）.结论 中重度强迫症患者具有较高的强迫信念,ICT信念是影响强迫症状严重程度的重要因素,特别是对强迫思维的影响.

Objective To understand the obsessive beliefs of the patients with obsessive compulsive disorder （OCD） of moderately and severe level and its relationship with symptoms,therefore providing reference for clinical treatment.Methods 100 patients with OCD and 105 cases of healthy people （HC） were assessed with the Obsessive Beliefs Questionnaire （OBQ-44）,the OCD patients were also assessed with Yale-Brown Obsessive Compulsive Scale （Y-BOCS）to know about the severity.Pearson correlation coefficient between obsessive beliefs and the severity of obsessive compulsive symptoms was carried out.Results OCD group scored higher than HC group in the sense of responsibility/threat estimate （RT）,perfectionism/certainty （PC）,importance/control thoughts （ICT） and Obsessive Beliefs Questionnaire Total score （OBQ-T;t=4.82,3.84,3.55,4.62,all P＜0.01）.Female patients scored higher than male patients in compulsive behavior score（12.5±4.2 vs.9.9± 3.8）and total symptom scores （26.7± 5.3 vs.23.5±4.9;t=3.29,3.10,both P＜0.01）.Obsessive beliefs score had the positive correlations with age at first onset,duration,obsessive thoughts and compulsive behavior score and total symptom score （r=0.40,0.23,0.46,0.42,0.48,all P＜0.01）.ICT and obsessive thoughts and total symptom scores were positively correlated （r=0.21,0.20,both P＜0.05）.Obsessive thoughts symptoms score and total symptom scores were correlated with ICT score （β3 =0.21,0.07,both P＜0.05）.Conclusion Patients with OCD of moderately and severe level have high obsessive belief,and ICT belief is the important factor related to the severity of the symptoms,especially in the obsessive thoughts symptoms.