Associations in the longitudinal course of body dysmorphic disorder with major depression, obsessive-compulsive disorder, and social phobia
Associations in the longitudinal course of body dysmorphic disorder with major depression, obsessive-compulsive disorder, and social phobia
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DOI：
10.1016/j.jpsychires.2005.10.001
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发表时间：
2006-06-01
影响因子：
4.8
通讯作者：
Stout, Robert L.
中科院分区：
文献类型：
--
作者：
Phillips, Katharine A.;Stout, Robert L.
躯体变形障碍(BDD)是一种损害和相对常见的疾病，与某些轴I障碍有很高的共病。然而，BDD和共病障碍之间的纵向联系以前还没有被研究过。这些信息可能会阐明BDD与假定的“近邻”障碍的关系的性质，如严重的抑郁症、强迫症(OCD)和社交恐惧症。这项研究在对BDD病程的首次前瞻性纵向研究中，对161名参与者进行了1-3年的随访，研究了BDD和这些共病障碍之间的时间变化相关性。我们发现BDD与重度抑郁症有显著的纵向关联--即BDD状态的改变与重度抑郁症在时间上密切相关，重度抑郁症的改善预测BDD的缓解，反过来，BDD的改善预测抑郁症的缓解。我们还发现，强迫症的改善预示着BDD的缓解，但BDD的改善并不能预测强迫症的缓解。没有发现BDD和社交恐惧症的显著纵向关联(尽管对强迫症和社交恐惧症的分析结果在数字上不太稳定)。这些发现提示(但不能证明)BDD可能在病因上与严重的抑郁症和强迫症有关，即BDD可能是推测的强迫症谱系和情感谱系的成员。然而，BDD似乎并不是这些共病障碍的简单症状，因为BDD症状在相当大比例的缓解了这些共病障碍的受试者中持续存在。由于这一问题具有重要的理论和临床意义，还需要更多的研究来阐明BDD与常见共生疾病的关系的性质。(C)2005爱思唯尔有限公司。保留所有权利。
Body dysmorphic disorder (BDD) is an impairing and relatively common disorder that has high comorbidity with certain Axis I disorders. However, the longitudinal associations between BDD and comorbid disorders have not previously been examined. Such information may shed light on the nature of BDD's relationship to putative "near-neighbor" disorders, such as major depression, obsessive-compulsive disorder (OCD), and social phobia. This study examined time-varying associations between BDD and these comorbid disorders in 161 participants over 1-3 years of follow-up in the first prospective longitudinal study of the course of BDD. We found that BDD had significant longitudinal associations with major depression - that is, change in the status of BDD and major depression was closely linked in time, with improvement in major depression predicting BDD remission, and, conversely, improvement in BDD predicting depression remission. We also found that improvement in OCD predicted BDD remission, but that BDD improvement did not predict OCD remission. No significant longitudinal associations were found for BDD and social phobia (although the results for analyses of OCD and social phobia were less numerically stable). These findings suggest (but do not prove) that BDD may be etiologically linked to major depression and OCD, i.e., that BDD may be a member of both the putative OCD spectrum and the affective spectrum. However, BDD does not appear to simply be a symptom of these comorbid disorders, as BDD symptoms persisted in a sizable proportion of subjects who remitted from these comorbid disorders. Additional studies are needed to elucidate the nature of BDD's relationship to commonly co-occurring disorders, as this issue has important theoretical and clinical implications. (c) 2005 Elsevier Ltd. All rights reserved.