伴囤积症状强迫症患者的临床特征研究

Clinical characteristics of the obsessive-compulsive disorder patients with hoarding symptoms

目的·探究伴囤积症状强迫症患者的临床特征,分析与囤积症状相关的危险因素。方法·共入组247例强迫症患者,137名健康对照。强迫症患者根据有无囤积症状被分为囤积组和非囤积组。采用耶鲁-布朗强迫症状量表、汉密尔顿抑郁量表、汉密尔顿焦虑量表、大五人格量表简化版以及强迫信念问卷测量3组被试的强迫症严重程度、抑郁及焦虑水平、人格特征、强迫信念等,比较组间差异,并应用Logistic回归分析囤积症状的相关因素。结果·不论是否伴有囤积症状,强迫症患者的抑郁水平、焦虑水平、神经质得分及强迫信念得分均显著高于健康对照(均P=0.000)。相比于非囤积组,囤积组的外向性水平显著降低(P=0.000),完美主义/确定性水平显著升高(P=0.037),在优柔寡断(P=0.003)、过度责任心(P=0.006)和病理性迟缓(P=0.000)方面的得分更高。Logistic回归模型中年龄(OR=0.94)、外向性得分(OR=0.89)和病理性迟缓得分(OR=2.50)具有统计学意义(均P<0.05)。结论·强迫症患者伴有囤积症状的风险随着年龄的增长和外向性水平的提高而减小,随着病理性迟缓水平增加而增大。

Objective·To explore the clinical characteristics of the obsessive-compulsive disorder(OCD)patients with hoarding symptoms and analyze the risk factors related to hoarding symptoms.Methods·A total of 247 OCD patients and 137 healthy controls(HC)were enrolled.The OCD patients were divided into hoarding group and non-hoarding group according to hoarding symptoms.Yale-Brown Obsessive-Compulsive Scale,Hamilton Depression Scale,Hamilton Anxiety Scale,Neuroticism Extraversion Openness Five-Factor Inventory and Obsessive Belief Questionnaire-44 were used to measure the severity of OCD,levels of depression and anxiety,personality characteristics and obsessive-compulsive beliefs of the three groups.The differences among the groups were compared,and Logistic regression was used to analyze the related factors of hoarding symptoms.Results·Regardless of hoarding symptoms,the scores of depression,anxiety,neuroticism and obsessive beliefs in the patients with OCD were significantly higher than those in the healthy controls(all P=0.000).Compared with OCD/non-hoarding group,OCD/hoarding group had a significantly lower level of extroversion(P=0.000),a significantly higher level of perfectionism/certainty(P=0.037),and higher scores in indecisiveness(P=0.003),pathological responsibility(P=0.006)and pathological slowness(P=0.000).There was statistical significance in age(OR=0.94),extraversion score(OR=0.89)and pathological retardation score(OR=2.50)in Logistic regression model(all P<0.05).Conclusion·The risk of hoarding symptoms in the OCD patients decreases with the increase of age and extroversion level,and increases with the increase of pathological retardation level.