Clinical correlates of recurrent major depression in obsessive-compulsive disorder

Clinical correlates of recurrent major depression in obsessive-compulsive disorder
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DOI:
10.1002/da.20024
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发表时间:
2004-01-01
影响因子:
7.4
通讯作者:
Nestadt, G
Nestadt, G
中科院分区:
医学1区
文献类型:
--
作者:
Hong, JP;Samuels, J;Nestadt, G

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重度抑郁症是强迫症(OCD)中最常见的合并症。本研究探讨强迫症患者复发性重度抑郁障碍(RDD)发展的相关因素。精神病学家或临床心理学家使用情感障碍和精神分裂症终生焦虑量表(SADS-LA)对80例强迫症患者和73例对照先证者进行了检查。两位经验丰富的精神科医生独立审查了所有临床材料,并使用DSM-IV标准做出了最终一致的诊断。比较单独的强迫症患者(n = 21)和强迫症合并RDD患者(n = 41)之间的强迫症和RDD家族史、其他合并症、强迫症症状和疾病严重程度。与无RDD的强迫症先证者相比,有RDD的强迫症先证者首次诊断年龄更早,强迫症症状更严重,有RDD家族史的可能性更大。社交恐惧症、分离焦虑障碍和身体畸形障碍在合并症组中发生率更高。在多元logistic回归模型中,只有早期强迫症诊断与RDD显著相关。早期出现强迫症会增加强迫症患者患抑郁症的风险。(C) 2004 Wiley-Liss, Inc。
Major depressive disorder is the most frequent comorbid condition in obsessive-compulsive disorder (OCD). This study investigated factors associated with the development of recurrent major depressive disorder (RDD) in patients with OCD. Eighty OCD cases and 73 control probands were examined by psychiatrists or clinical psychologists using the Schedule for Affective Disorders and Schizophrenia-Lifetime Anxiety (SADS-LA). Two experienced psychiatrists independently reviewed all clinical materials and made final consensus diagnoses using DSM-IV criteria. Family history of OCD and RDD, additional comorbid disorders, OCD symptoms and illness severity were compared between persons with OCD alone (n = 21) and OCD with RDD (n = 41). Compared to OCD probands without RDD, OCD probands with RDD bad earlier age at first diagnosis, more severe obsessive-compulsive symptoms, and were more likely to have a family history of RDD. Social phobia, separation anxiety disorder, and body dysmorphic disorder occurred more frequently in the comorbid group. In a multiple logistic regression model, only early age of OCD diagnosis was significantly associated with RDD. Early age at onset of OCD increases the risk of depressive disorder in individuals with OCD. (C) 2004 Wiley-Liss, Inc.