The importance of insight, avoidance behavior, not-just-right perception and personality traits in pediatric obsessive-compulsive disorder (OCD): a naturalistic clinical study
The importance of insight, avoidance behavior, not-just-right perception and personality traits in pediatric obsessive-compulsive disorder (OCD): a naturalistic clinical study
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DOI：
10.1080/08039488.2018.1486454
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发表时间：
2018-01-01
影响因子：
1.8
通讯作者：
Parner, Erik
中科院分区：
文献类型：
--
作者：
Nissen, Judith Becker;Parner, Erik
目的：本探索性自然主义研究的主要目的是检查洞察力差、回避行为和不正确感觉与强迫症（OCD）症状、基线严重程度评分、合并症和人格特征等基线参数的关系。第二个目的是研究洞察力、回避和不正确的感觉如何影响治疗结果。材料和方法：共有317份来自丹麦一家专门的强迫症诊所的强迫症儿童和青少年的医疗记录，记录了基线参数和治疗结果。所有的信息都被使用了。结果：逃避行为和洞察力差与基线严重程度增加有关，而不正确的感知则无关。逃避行为与污染/清洁亚型有关，而不正确的感觉与囤积/对称亚型有关。较低的洞察力和回避行为与合并症有关。在治疗后，不正确的感知与复发风险相关，而较低的洞察力与获得缓解负相关。回避行为降低了缓解的可能性，增加了提供的会话次数以及规定SRI的可能性。不同的人格特征与治疗结果相关。结论：洞察力、回避行为和不正确的感知似乎对基线严重程度和治疗后结果很重要。基线检查应包括系统描述，以指导治疗。本研究是一项探索性研究，描述了一个自然的临床人群。因此，在解释结果时应该考虑到一些限制。有必要对洞察力、回避行为和不正确感知的重要性进行更系统的研究。
Purpose: The primary aim of the present explorative naturalistic study was to examine the association of poor insight, avoidance behavior, and not-just-right sensation with baseline parameters including obsessive-compulsive disorder (OCD) symptoms, baseline severity scores, comorbidity, and personality traits. A second aim was to examine how insight, avoidance and not-just-right sensation influence treatment outcome.Materials and methods: In total, 317 medical records from children and adolescents with OCD referred to a specialized OCD clinic in Denmark were recorded for baseline parameters and treatment outcome. All information was used.Results: Avoidance behavior and poor insight were associated with an increased baseline severity, whereas not-just-right perception was not. Avoidance behavior was associated with the contamination/cleaning subtype, and a not-just-right sensation with the hoarding/symmetry subtype. Lower insight and avoidance behavior were associated with comorbid conditions. At post-treatment, not-just-right perception was associated with a risk of relapse, whereas lower insight was negatively associated with gaining remission. Avoidance behavior reduced the probability of remission and increased the number of offered sessions as well as and the likelihood of having SRI prescribed. Different personality traits were associated with treatment outcome.Conclusion: Insight, avoidance behavior, and not-just-right perceptions seem important for baseline severity and post-treatment outcome. Baseline examination should include a systematic description, which could guide treatment. The present study is an explorative study describing a naturalistic clinical population. Therefore, a number of limitations should be taken into consideration when interpreting the results. More systematic studies on the importance of insight, avoidance behavior and not-just-right perceptions are warranted.