Tourette's disorder with and without obsessive-compulsive disorder in adults: Are they different?
Tourette's disorder with and without obsessive-compulsive disorder in adults: Are they different?
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DOI：
10.1097/00005053-199804000-00001
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发表时间：
1998-04-01
影响因子：
1.9
通讯作者：
Jenike, MA
中科院分区：
文献类型：
--
作者：
Coffey, BJ;Miguel, EC;Jenike, MA
临床研究已经从家族遗传学、现象学、共病和自然病史的角度记录了抽动症(TD)和强迫症(OCD)之间的双向重叠。抽动症合并强迫症(TD+OCD)的患者，可能是一种亚型，具有两者的共同特征。这项探索性研究的目的是评估TD、OCD和TD+OCD患者的相关性，以确定TD+OCD是TD、OCD的一个亚型，还是两者的相加形式。61名患有TD、强迫症或TD+强迫症的受试者接受了DSM-III-R的结构化临床访谈，并补充了其他模块。这三个组在双相情感障碍(p<；0.04)、社交恐惧症(p<；0.02)、躯体变形障碍(p<；.002)、注意力缺陷多动障碍(p<；0.03)和物质使用障碍(p<；0.04)的患病率上存在差异。这些发现是由于与TD和OCD组相比，TD+OCD组的疾病发生率升高所致。这些发现最符合这样一种假设，即TD+OCD是一种比TD和OCD更严重的疾病，在病因上与TD的联系可能比与OCD的联系更密切。这些发现突显了评估TD和强迫症患者精神共病的全谱的重要性。
Clinical research has documented a bidirectional overlap between Tourette's disorder (TD) and obsessive-compulsive disorder (OCD) from familial-genetic, phenomenological, comorbidity, and natural history perspectives. Patients with Tourette's disorder plus obsessive-compulsive disorder (TD+OCD), a putative subtype, share features of both. The purpose of this exploratory study was to evaluate correlates of patients with TD, OCD, and TD+OCD to determine whether TD+OCD is a subtype of TD, OCD, or an additive form of both. Sixty-one subjects with TD, OCD, or TD+OCD were evaluated with the Structured Clinical Interview for DSM-III-R supplemented with additional modules. The three groups differed in the rates of bipolar disorder (p < .04), social phobia (p < .02), body dysmorphic disorder (p < .002), attention deficit hyperactivity disorder (p < .03), and substance use disorders (p < .04). These findings were accounted for by the elevated rates of the disorders in the TD+OCD group compared with the TD and OCD groups. These finding are most consistent with the hypothesis that TD+OCD is a more severe disorder than TD and OCD and may be more etiologically linked to TD than to OCD. These findings highlight the importance of assessment of the full spectrum of psychiatric comorbidity in patients with TD and OCD.