Obsessive-compulsive disorder in the community: 12-month prevalence, comorbidity and impairment
Obsessive-compulsive disorder in the community: 12-month prevalence, comorbidity and impairment
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DOI：
10.1007/s00127-010-0337-5
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发表时间：
2012-03-01
影响因子：
4.4
通讯作者：
Lieb, Roselind
中科院分区：
文献类型：
--
作者：
Adam, Yuki;Meinlschmidt, Gunther;Lieb, Roselind
背景虽然阈下条件与许多障碍的损害有关，但在一般人群中低于DSM-IV诊断阈值的强迫症（OCD）的研究是有限的。目的估计DSM-IV 12个月的患病率、合并症和OCD的损害，阈下OCD（即，满足一些但不是全部核心DSM-IV标准），和强迫症状（OCS）（即，方法数据来自德国国家健康访谈和检查调查-心理健康补充资料结果12个月强迫症患病率为0.7%，阈下强迫症患病率为4.5%，OCS为8.3%。与无OCS的受试者相比，所有三组受试者均显示出更高的合并症（比值比[OR] >= 3.3）。强迫症、阈下强迫症和强迫症都与物质滥用/依赖、情绪、焦虑和躯体形式障碍的几率增加相关，尤其与可能的精神病性障碍（OR>= 4.1）和双相情感障碍（OR>= 4.7）有很强的相关性。在所有三个组的参与者表现出较高的损害（OR>= 3.1）和医疗保健利用（OR>= 2.4），相比那些没有OCS，即使在控制了协变量。结论个人与阈下强迫症和OCS，目前没有捕获的DSM-IV强迫症的标准，但显示大量的合并症，损害和医疗保健利用。这应该在未来的概念化和分类的强迫症和临床护理考虑。
Background Although subthreshold conditions are associated with impairment in numerous disorders, research on obsessive-compulsive disorder (OCD) below the diagnostic threshold of DSM-IV in the general population is limited.Purpose To estimate the DSM-IV 12-month prevalence, comorbidity and impairment of OCD, subthreshold OCD (i.e., fulfilling some but not all core DSM-IV criteria), and obsessive-compulsive symptoms (OCS) (i.e., endorsement of OCS without fulfilling any core DSM-IV criteria) in a general population sample.Methods Data from the German National Health Interview and Examination Survey-Mental Health Supplement (N = 4181, age 18-65 years), based on the standardized diagnostic Munich Composite International Diagnostic Interview.Results The 12-month prevalence of OCD was 0.7%, subthreshold OCD was 4.5%, and OCS was 8.3%. Subjects in all three groups showed higher comorbidity (odds ratios [ORs] >= 3.3), compared to those without OCS. The OCD, subthreshold OCD and OCS were all associated with increased odds of substance abuse/dependence-, mood-, anxiety- and somatoform disorders, with especially strong associations with possible psychotic disorder (ORs >= 4.1) and bipolar disorders (ORs >= 4.7). Participants in all three groups showed higher impairment (ORs >= 3.1) and healthcare utilization (ORs >= 2.4), compared to those without OCS, even after controlling for covariates.Conclusions Individuals with subthreshold OCD and OCS, not currently captured by DSM-IV OCD criteria, nevertheless show substantial comorbidity, impairment and health-care utilization. This should be taken into account in future conceptualization and classification of OCD and clinical care.