Treatment response, symptom remission, and wellness in obsessive-compulsive disorder.
Treatment response, symptom remission, and wellness in obsessive-compulsive disorder.
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DOI：
10.4088/jcp.12m07789
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发表时间：
2013-07
期刊：
影响因子：
--
通讯作者：
Foa EB
中科院分区：
文献类型：
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作者：
Farris SG;McLean CP;Van Meter PE;Simpson HB;Foa EB
强迫症（OCD）的定义是侵入性的，不想要的想法，图像或冲动，以及经常试图减轻焦虑的重复行为或精神行为。治疗强迫症的最终目标是减轻症状，以及帮助患者实现“健康”，但目前还没有广泛接受的，经验支持的标准来确定强迫症的健康。在以前研究的基础上，目前的研究汇集了1990- 2011年间进行的四项强迫症治疗试验（N = 288）的数据，以检查耶鲁-布朗强迫症量表（Y-BOCS）评分，该评分最可靠地确定了对治疗有反应的患者，那些达到症状缓解的患者和那些达到健康的患者。信号检测分析显示，治疗前后Y-BOCS降低≥ 35%最能预测治疗应答，如临床总体疗效（CGI-改善）所定义。治疗后Y-BOCS评分≤ 14是症状缓解的最佳预测因子，其中评分≤ 12是健康的最佳预测因子，定义为通过CGI-严重程度定义的症状缓解、通过生活质量享受和满意度问卷（QLES-Q）测量的良好生活质量以及通过社会适应量表（SAS-SR）评估的高水平适应功能。经验支持的标准定义健康的强迫症可以促进治疗结果的研究之间的比较，并告知临床治疗计划。
Obsessive-compulsive disorder (OCD) is defined both by intrusive, unwanted thoughts, images or impulses and by repetitive behavioral or mental acts that are often performed to try to alleviate anxiety. The ultimate goal of treatment for OCD is to reduce the symptoms, as well as help patients achieve “wellness”, however currently there are no widely accepted, empirically supported criteria for determining wellness in OCD. Building on previous research, the current study pooled data from four OCD treatment trials (N = 288) that took place between 1990–2011to examine the Yale-Brown Obsessive Compulsive Disorder Scale (Y-BOCS) score that most reliably identified patients who responded to treatment, those who achieved symptom remission and those who achieved wellness. Signal detection analyses showed that a pre- to post-treatment reduction of ≥ 35% on the Y-BOCS was most predictive of treatment response, as defined by the Clinical Global Impressions (CGI-Improvement). A post-treatment Y-BOCS score of ≤ 14 was the best predictor of symptom remission, where a score of ≤ 12 was the best predictor of wellness, as defined by symptom remission defined by the CGI-Severity, good quality of life as measured by the Quality of Life Enjoyment and Satisfaction Questionnaire (QLES-Q) and a high-level of adaptive function as assessed by the Social Adjustment Scale (SAS-SR). Empirically supported criteria for defining wellness in OCD can facilitate comparisons across treatment outcome studies and inform clinical treatment planning.