Obsessive-Compulsive Symptomatology in Community Youth: Typical Development or a Red Flag for Psychopathology?
Obsessive-Compulsive Symptomatology in Community Youth: Typical Development or a Red Flag for Psychopathology?
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DOI：
10.1016/j.jaac.2018.06.038
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发表时间：
2019-02-01
影响因子：
13.3
通讯作者：
Gur, Raquel E.
中科院分区：
文献类型：
--
作者：
Barzilay, Ran;Patrick, Ariana;Gur, Raquel E.
目的：强迫症状（OCS）在整个发育过程中很常见，通常被认为是发育相关的。我们在一个未确定寻求心理健康帮助的大型社区青年样本中评估了自我报告的OCS的患病率和表型异质性。我们的目的是确定模式与严重的精神病理学的OCS，因此可能代表了“红旗”，值得psychiatric evaluation.Method：数据进行了分析，从青年费城神经发育队列（N = 7,054，年龄11-21岁，54%女性）。参与者接受了结构化的精神病学访谈，包括OCS（8种强迫症，8种强迫症和囤积症）和其他主要精神病理学领域的筛查。进行因子分析，以确定集群的OCS介绍。回归模型被用来调查与强迫症（OCD），抑郁发作，精神病，和自杀ideation.Results的阈值终身诊断的OCS的关联：OCS是常见的非心理健康寻求个人（38.2%），虽然只有3%符合阈值强迫症标准。OCS在女性参与者和青春期后更常见。因子分析产生了4个因子：F1 -坏想法; F2 -重复/检查; F3 -对称性; F4 -清洁/污染;和囤积作为一个单独的项目。所有的OCS都与较高的强迫症、抑郁症、精神病和自杀意念的发生率相关。然而，背书的F1症状，流行于20%以上的样本，表现出最实质性的协会与主要的精神conditions.Conclusion：OCS是常见的社区青年。虽然对于大多数青少年来说，OCS症状可能是良性的，但某些模式的OCS与主要的精神疾病有关。这些发现可能有助于识别有严重精神病理学风险的青年。
Objective: Obsessive-compulsive symptoms (OCS) are common throughout development and often considered developmentally appropriate. We evaluated the prevalence and phenotypic heterogeneity of self-reported OCS in a large community youth sample not ascertained for seeking mental-health help. We aimed to identify patterns in OCS that are associated with serious psychopathology and may thus represent a "red flag" that merits psychiatric evaluation.Method: Data were analyzed from youth from the Philadelphia Neurodevelopmental Cohort (N = 7,054, aged 11-21 years, 54% female). Participants underwent structured psychiatric interviews, including screening for OCS (8 obsessions, 8 compulsions, and hoarding) and other major psychopathology domains. Factor analysis was conducted to identify clustering of OCS presentation. Regression models were used to investigate association of OCS with threshold lifetime diagnoses of obsessive-compulsive disorder (OCD), depressive episode, psychosis, and suicide ideation.Results: OCS were common in non-mental health-seeking individuals (38.2%), although only 3% met threshold OCD criteria. OCS were more common in female participants and postpuberty. Factor analyses resulted in 4 factors: F1 - Bad Thoughts; F2 - Repeating/Checking; F3 - Symmetry; F4 - Cleaning/Contamination; and Hoarding as a separate item. All OCS were associated with higher rates of OCD, depression, psychosis, and suicide ideation. However, endorsement of F1 symptoms, prevalent in more than 20% of the sample, showed the most substantial associations with major psychiatric conditions.Conclusion: OCS are common in community youth. Although for most youths OCS symptoms may be benign, some patterns of OCS are associated with major psychiatric conditions. These findings may help to identify youth at risk for serious psychopathology.