Psychosocial stress predicts future symptom severities in children and adolescents with Tourette syndrome and/or obsessive-compulsive disorder
Psychosocial stress predicts future symptom severities in children and adolescents with Tourette syndrome and/or obsessive-compulsive disorder
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DOI：
10.1111/j.1469-7610.2006.01687.x
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发表时间：
2007-02-01
影响因子：
7.6
通讯作者：
Leckman, James F.
中科院分区：
文献类型：
--
作者：
Lin, Haiqun;Katsovich, Liliya;Leckman, James F.
背景：这项前瞻性纵向研究的目的是监测患有图雷特综合征（TS）和/或强迫症（OCD）的儿童和青少年与健康对照受试者相比的心理社会压力水平，并检查心理社会压力测量与抽动、强迫（OC）和抑郁症状严重程度波动之间的关系。方法：对 45 例病例和 41 名匹配的健康对照受试者在两年内的抽动、OC 和抑郁症状严重程度进行连续评级。心理社会压力的测量包括青少年自我报告、父母报告和临床医生对长期背景威胁的评级。使用不平衡重复测量的结构方程模型来评估社会心理压力的时间序列以及抽动、OC 和抑郁症状的严重程度。结果：患有 TS 和 OCD 的受试者比对照组经历了显着更多的社会心理压力。对心理社会压力的估计可以预测未来的抑郁症状。目前的社会心理压力水平也是未来 OC 症状严重程度的重要预测因素，但反之则不然。当前的 OC 症状严重程度是未来抑郁症状严重程度的预测因子，但反之则不然。即使在控制了实际年龄增长的影响之后，当前的社会心理压力和抑郁水平也是未来抽动严重程度的独立预测因素。结论：先前的心理社会逆境对未来抑郁症状的影响比对抽动和/或 OC 症状的影响更大。 OC 症状恶化也是未来抑郁症状的预测因素。实际年龄的增长与抽动严重程度的降低密切相关。
Background: The goals of this prospective longitudinal study were to monitor levels of psychosocial stress in children and adolescents with Tourette syndrome (TS) and/or obsessive-compulsive disorder (OCD) compared to healthy control subjects and to examine the relationship between measures of psychosocial stress and fluctuations in tic, obsessive-compulsive (OC), and depressive symptom severity. Methods: Consecutive ratings of tic, OC and depressive symptom severity were obtained for 45 cases and 41 matched healthy control subjects over a two-year period. Measures of psychosocial stress included youth self-report, parental report, and clinician ratings of long-term contextual threat. Structural equation modeling for unbalanced repeated measures was used to assess the temporal sequence of psychosocial stress with the severity of tic, OC and depressive symptoms. Results: Subjects with TS and OCD experienced significantly more psychosocial stress than did the controls. Estimates of psychosocial stress were predictive of future depressive symptoms. Current levels of psychosocial stress were also a significant predictor of future OC symptom severity, but not vice versa. Current OC symptom severity was a predictor of future depressive symptom severity, but not vice versa. Current levels of psychosocial stress and depression were independent predictors of future tic severity, even after controlling for the effect of advancing chronological age. Conclusions: The impact of antecedent psychosocial adversity is greater on future depressive symptoms than for tic and/or OC symptoms. Worsening OC symptoms are also a predictor of future depressive symptoms. Advancing chronological age is robustly associated with reductions in tic severity.