不同起病年龄强迫症患者及亲属的强迫信念和焦虑特质研究

Obsessive beliefs and anxiety traits in patients of obsessive-compulsive disorder with differ⁃ent onset ages and their relatives

目的:探究不同起病年龄的强迫症患者和亲属焦虑特质和强迫信念的差异及与疗效的相关性。方法:采用强迫信念问卷-44(OBQ-44)和状态特质焦虑问卷(STAI)对青少年期和成年期起病的强迫症患者和亲属进行评估,在治疗前和治疗8周后,采用耶鲁—布朗强迫量表(Y-BOCS)评估患者强迫症状。结果:与成年起病的强迫症患者相比,青少年起病的患者的强迫信念量表和状态特质焦虑问卷总分更高(t=2.090,P=0.043;t=2.327,P=0.025),两组患者亲属也表现出相似的趋势(t=2.901,P=0.006;t=3.357,P=0.002)。患者亲属的强迫信念和状态特质焦虑总分均与强迫症患者治疗前的强迫思维均呈正相关关系(r=0.393,P=0.012,r=0.557,P<0.001),强迫信念和焦虑状态/特质也与患者治疗前强迫行为呈正相关关系(r=0.320,P=0.044,r=0.662,P<0.001),患者亲属的焦虑特质与患者强迫症状减分呈负相关关系(r=-0.389,P=0.013)。结论:青少年起病强迫症患者和亲属具有更明显的强迫信念和焦虑状态/特质,患者亲属的认知特征与疾病严重程度和预后相关,因此在对强迫症,尤其是早年起病者需重视对患者和亲属认知特征的评估。

Objective:To explore the differences of obsessive beliefs and anxiety traits between patients with ob-sessive-compulsive disorder(OCD)and their relatives at different onset ages and their correlation with therapeu-tic effects.Methods:Obsessive Beliefs Questionnaire-44(OBQ-44)and State Trait Anxiety Inventory(STAI)were used to assess patients and relatives with OCD onset in adolescence and adulthood.Yale-brown Obsessive-Compulsive Scale(Y-BOCS)was used to assess obsessive-compulsive symptoms in patients.Results:Compared with adult-onset obsessive-compulsive disorder patients,adolescent-onset patients had higher total scores on the OBQ-44 and the STAI(t=2.090,P=0.043;t=2.327,P=0.025),the relatives of the two groups also showed a simi-lar trend(t=2.901,P=0.006;t=3.357,P=0.002).The total scores of obsessive beliefs and anxiety states/traits of the relatives of patients were positively correlated with the obsessive thoughts of patients before treatment(r=0.393,P=0.012,r=0.557,P<0.001).The obsessive beliefs and anxiety states/traits were also positively correlated with the compulsive behaviors of patients before treatment(r=0.320,P=0.044,r=0.662,P<0.001).The anxiety traits of the relatives of patients were negatively correlated with the reduction of obsessive-compulsive symptoms(r=-0.389,P=0.013).Conclusion:Adolescence-onset patients with OCD and relatives have more pronounced ob-sessive beliefs and anxiety states/traits,and the cognitive characteristics of relatives are associated with disease se-verity and prognosis.Therefore,it is necessary to pay attention to the evaluation of cognitive characteristics of pa-tients and relatives in OCD,especially in patients with early onset.