Meta-analysis of the symptom structure of obsessive-compulsive disorder.
Meta-analysis of the symptom structure of obsessive-compulsive disorder.
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DOI：
10.1176/appi.ajp.2008.08020320
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发表时间：
2008-12
期刊：
影响因子：
--
通讯作者：
Leckman JF
中科院分区：
文献类型：
--
作者：
Bloch MH;Landeros-Weisenberger A;Rosario MC;Pittenger C;Leckman JF
强迫症（OCD）是一种临床异质性疾病。这种异质性可能会降低遗传学、神经影像学和临床试验的效力。尽管研究数量不断增加，但关于强迫症症状的确切因子结构仍存在争议。作者进行了一项荟萃分析以确定耶鲁 - 布朗强迫症量表症状检查表的因子结构。
如果研究涉及强迫症患者，并且对13个耶鲁 - 布朗强迫症量表症状检查表类别或其中的项目进行了探索性因子分析，则该研究被纳入。在SAS 9.1中使用PROC FACTOR CORR进行方差极大旋转，从样本量加权的共现矩阵中提取因子。进行分层荟萃分析以分别确定涉及儿童和成人的研究中强迫症的因子结构。
共纳入21项研究，涉及5124名参与者。产生的四个因子是：1）对称性：对称性强迫观念以及重复、排序和计数强迫行为；2）禁忌思维：攻击性、性、宗教和躯体强迫观念以及检查强迫行为；3）清洁：清洁和污染；4）囤积：囤积强迫观念和强迫行为。对成人研究的因子分析得出的因子结构与整体荟萃分析相同。仅针对儿童的研究的因子分析有所不同，即检查在对称性因子上的载荷最高，而躯体强迫观念在清洁因子上的载荷最高。
一个四因子结构解释了强迫症临床症状中很大一部分的异质性。需要进一步的项目水平因子分析以确定其他躯体和检查类强迫症症状的适当归类。
OCD is a clinically heterogeneous condition. This heterogeneity has the potential to reduce power in genetic, neuroimaging, and clinical trials. Despite a mounting number of studies, there remains debate regarding the exact factor structure of OCD symptoms. The authors conducted a meta-analysis to determine the factor structure of the Yale-Brown Obsessive Compulsive Scale Symptom Checklist. Studies were included if they involved subjects with OCD and included an exploratory factor analysis of the 13 Yale-Brown Obsessive Compulsive Scale Symptom Checklist categories or the items therein. A varimax-rotation was conducted in SAS 9.1 using the PROC FACTOR CORR to extract factors from sample-size weighted co-occurrence matrices. Stratified meta-analysis was conducted to determine the factor structure of OCD in studies involving children and adults separately. Twenty-one studies involving 5,124 participants were included. The four factors generated were 1) symmetry: symmetry obsessions and repeating, ordering, and counting compulsions; 2) forbidden thoughts: aggression, sexual, religious, and somatic obsessions and checking compulsions, 3) cleaning: cleaning and contamination, and 4) hoarding: hoarding obsessions and compulsions. Factor analysis of studies including adults yielded an identical factor structure compared to the overall meta-analysis. Factor analysis of child-only studies differed in that checking loaded highest on the symmetry factor and somatic obsessions, on the cleaning factor. A four-factor structure explained a large proportion of the heterogeneity in the clinical symptoms of OCD. Further item-level factor analyses are needed to determine the appropriate placement of miscellaneous somatic and checking OCD symptoms.
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作者：
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通讯作者：
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影响因子：
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作者：
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DOI：
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发表时间：
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影响因子：
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作者：
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