Symptom stability in adult obsessive-compulsive disorder: Data from a naturalistic two-year follow-up study
Symptom stability in adult obsessive-compulsive disorder: Data from a naturalistic two-year follow-up study
复制标题
DOI：
10.1176/appi.ajp.159.2.263
复制
发表时间：
2002-02-01
影响因子：
17.7
通讯作者：
Jenike, MA
中科院分区：
文献类型：
--
作者：
Mataix-Cols, D;Rauch, SL;Jenike, MA
目的：尽管有一些关于儿童和青少年强迫症（OCD）症状稳定性的证据，但对于成年强迫症患者症状的纵向病程知之甚少。本研究对前瞻性随访2年的成年患者的个体症状和强迫症症状维度的时间稳定性进行了系统研究。
方法：来自美国三个地点的117名成年强迫症门诊患者在2年期间接受了4次耶鲁 - 布朗强迫症量表症状清单检查。在初次筛查后6个月、1年和2年时，分别有81名（69%）、83名（71%）和67名（57%）患者可参与研究。采用不同的分析方法评估先前确定的症状维度内和维度间强迫症症状的稳定性。
结果：在大多数情况下，患者在整个随访过程中症状保持不变，尽管有些症状比其他症状更稳定。对于发生变化的症状，变化发生在症状维度内而非维度之间；从一个维度到另一个维度的质的转变很少见。某种特定症状存在的最强预测因素是过去曾有过该症状。尽管大多数患者在随访期间接受了药物和行为治疗，但症状维度内的变化不能用随时间推移的整体临床改善来解释。
结论：成年强迫症患者的症状可能比以前认为的在时间上更稳定，一些症状在症状维度内有增减，且很少涉及维度间的转变。需要涉及更大样本的更长时间的随访研究，以更好地理解强迫症症状随时间的波动情况。
Objective: Little is known about the longitudinal course of symptoms in adult patients with obsessive-compulsive disorder (OCD), although some evidence exists regarding symptom stability in children and adolescents. This study systematically investigated the temporal stability of individual symptoms and symptom dimensions of OCD in adult patients who were followed prospectively for 2 years.Method: One hundred seventeen adult outpatients with OCD from three U.S. sites were administered the Yale-Brown Obsessive Compulsive Scale symptom checklist four times over a period of 2 years. Eighty-one (69%), 83 (71%), and 67 (57%) patients were available 6 months, 1 year, and 2 years after initial screening, respectively. Different analytic methods assessed the stability of OCD symptoms within and between previously identified symptom dimensions.Results: For the most part, patients maintained their symptoms throughout follow-up, although some symptoms were more stable than others. For the symptoms that changed, changes occurred within rather than between symptom dimensions; qualitative shifts from one dimension to another were rare. The strongest predictor of the presence of a particular symptom was having had that symptom in the past. Although most patients had received pharmacological and behavioral treatment during the follow-up period, changes within symptom dimensions could not be explained by overall clinical improvement over time.Conclusions: Symptoms of adult patients with OCD might be more stable across time than previously thought, with some symptoms waxing and waning within symptom dimensions and rarely involving shifts between dimensions. Longer follow-up studies involving larger samples are needed to better understand the fluctuations of OCD symptoms across time.