Directionality of change in obsessive compulsive disorder and depression over six years of prospective follow-up.
Directionality of change in obsessive compulsive disorder and depression over six years of prospective follow-up.
复制标题
六年前瞻性随访中强迫症和抑郁症的变化方向。
DOI：
10.1016/j.jpsychires.2022.11.034
复制
发表时间：
2023
影响因子：
4.8
通讯作者：
Boisseau,ChristinaL
中科院分区：
文献类型：
--
作者：
Belli,GinaM;Law,Clara;Mancebo,Maria;Eisen,Jane;Rasmussen,Steven;Boisseau,ChristinaL
重度抑郁障碍（MDD）通常与强迫症（OCD）共病，但对强迫症与抑郁症状之间的关系的方向性知之甚少。我们的目的是研究强迫症症状对抑郁症状的影响，反之亦然，持续一段时间。这是首次在大量临床样本中评估强迫症和抑郁症之间关系的纵向研究之一。参与者（n = 324）是最初诊断为强迫症的寻求治疗的成年人。在六年的随访期间，每年对强迫症和抑郁症状进行评估。采用随机截距交叉滞后面板模型（RI-CLPM）比较单向和双向模型随时间的变化。最佳拟合和最简洁的模型包括强迫症症状预测抑郁症状的路径，但反之则不然。某一年强迫症症状的严重程度可以预测明年抑郁症的严重程度。然而，在这个样本中，抑郁的严重程度并不能预测明年强迫症症状的严重程度。我们的研究结果表明，抑郁症的严重程度可能次于强迫症症状，治疗强迫症应优先于治疗抑郁症。
Major Depressive Disorder (MDD) is often comorbid with obsessive-compulsive disorder (OCD) yet little is known about the directionality of the association between OCD and depression symptoms. We aim to investigate the effect OCD symptoms has on depression symptoms and vice versa over an extended period of time. This is one of the first longitudinal studies to evaluate the relationship between OCD and depression in a large clinical sample. Participants (n = 324) were treatment-seeking adults with a primary diagnosis of OCD. OCD and depression symptoms were assessed annually over the six-year follow-up period. Random intercepts cross-lagged panel models (RI-CLPM) were conducted to compare unidirectional and bidirectional models over time. The best-fitting and most parsimonious model included paths with OCD symptoms predicting depression symptoms, but not vice versa. OCD symptom severity in a given year predicted next year depression severity. However, depression severity did not predict next-year OCD symptom severity in this sample. Our results suggest that depression severity may be secondary to OCD symptoms and treating OCD should be prioritized over treating depression.