Paediatric Obsessive-Compulsive Disorder and Depressive Symptoms: Clinical Correlates and CBT Treatment Outcomes.
Paediatric Obsessive-Compulsive Disorder and Depressive Symptoms: Clinical Correlates and CBT Treatment Outcomes.
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DOI：
10.1007/s10802-014-9943-0
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发表时间：
2015-07
影响因子：
3.6
通讯作者：
Krebs, G.
中科院分区：
文献类型：
--
作者：
Brown, H. M.;Lester, K. J.;Jassi, A.;Heyman, I.;Krebs, G.
关键词：
抑郁症经常与儿童强迫症（OCD）同时发生，但抑郁症对CBT结果的临床相关性和影响仍不清楚。在儿科专科OCD诊所样本（N = 295;平均年龄= 15 [7 - 18]岁，42%为女性）中，使用抑郁症的维度（Beck抑郁量表-青年; n = 261）和诊断（发育和健康评估; n = 127）测量，检查抑郁症的患病率和临床相关性。在接受CBT的子样本中检查了抑郁症状和疑似障碍对治疗后强迫症严重程度的影响，有或没有SSRI药物（N = 100）。51%的患者报告中度或极度升高的抑郁症状，26%（95%CI：18 - 34）符合疑似抑郁障碍的标准。在CBT之前，抑郁症状和抑郁障碍与更严重的强迫症症状严重程度和整体功能相关。患有抑郁症的人更可能是女性，有精神病住院治疗，不太可能上学（ps < 0.01）。强迫症和抑郁症状的严重程度显着降低后CBT。抑郁症状和抑郁障碍预测治疗后更严重的强迫症严重程度（βs = 0.19和0.26，ps < 0.05），但当控制治疗前的强迫症严重程度时变得不显著（βs = 0.05和0.13，ns）。抑郁症在儿童强迫症中很常见，并且与更严重的强迫症和更差的功能有关。然而，抑郁症的严重程度在强迫症的CBT过程中降低，并且与更差的结果无关，支持在存在抑郁症状的情况下照常治疗的建议。本文的在线版本（doi：10.1007/s10802-014-9943-0）包含补充材料，可供授权用户使用。
Depression frequently co-occurs with paediatric obsessive-compulsive disorder (OCD), yet the clinical correlates and impact of depression on CBT outcomes remain unclear. The prevalence and clinical correlates of depression were examined in a paediatric specialist OCD-clinic sample (N = 295; Mean = 15 [7 – 18] years, 42 % female), using both dimensional (Beck Depression Inventory-youth; n = 261) and diagnostic (Development and Wellbeing Assessment; n = 127) measures of depression. The impact of depressive symptoms and suspected disorders on post-treatment OCD severity was examined in a sub-sample who received CBT, with or without SSRI medication (N = 100). Fifty-one per-cent of patients reported moderately or extremely elevated depressive symptoms and 26 % (95 % CI: 18 – 34) met criteria for a suspected depressive disorder. Depressive symptoms and depressive disorders were associated with worse OCD symptom severity and global functioning prior to CBT. Individuals with depression were more likely to be female, have had a psychiatric inpatient admission and less likely to be attending school (ps < 0.01). OCD and depressive symptom severity significantly decreased after CBT. Depressive symptoms and depressive disorders predicted worse post-treatment OCD severity (βs = 0.19 and 0.26, ps < 0.05) but became non-significant when controlling for pre-treatment OCD severity (βs = 0.05 and 0.13, ns). Depression is common in paediatric OCD and is associated with more severe OCD and poorer functioning. However, depression severity decreases over the course of CBT for OCD and is not independently associated with worse outcomes, supporting the recommendation for treatment as usual in the presence of depressive symptoms. The online version of this article (doi:10.1007/s10802-014-9943-0) contains supplementary material, which is available to authorized users.
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DOI：
10.1176/appi.ajp.2008.08020320
发表时间：
2008-12
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Bloch MH;Landeros-Weisenberger A;Rosario MC;Pittenger C;Leckman JF
通讯作者：
Leckman JF
影响因子：
6.4
作者：
Ivarsson, Tord;Melin, Karin;Wallin, Lena
通讯作者：
Wallin, Lena
影响因子：
7.4
作者：
Hong, JP;Samuels, J;Nestadt, G
通讯作者：
Nestadt, G
影响因子：
7.4
作者：
Fernandez de la Cruz, Lorena;Barrow, Faye;Mataix-Cols, David
通讯作者：
Mataix-Cols, David
影响因子：
11.3
作者：
Hasler, G;LaSalle-Ricci, VH;Murphy, DL
通讯作者：
Murphy, DL