摘要
目的探究不恰当感在强迫症患者中的临床表现及其特征,揭示不恰当感与强迫症状的关系,并初步了解临床治疗对不恰当感的影响。方法前瞻性收集2021年3月至2022年3月在首都医科大学附属北京安定医院门诊就诊的91例强迫症患者的临床资料。根据患者在入院前1个月是否接受过治疗分为强迫症未治疗组(40例)和强迫症已治疗组(51例),其中强迫症未治疗组包括男24例、女16例,年龄18~60(29.3±8.1)岁;强迫症已治疗组包括男23例、女28例,年龄18~60(30.5±8.5)岁。同期招募年龄相匹配的健康对照者(健康对照组)50名,其中男25名,女25名,年龄18~60(30.8±8.9)岁。使用不恰当感体验问卷修订版(Not Just Right Experiences-Questionnaire-Revised,NJRE-Q-R)评估被试的不恰当感特征和程度,同时使用耶鲁-布朗强迫量表(Yale-Brown Obsessive-Compulsive Scale,Y-BOCS)、耶鲁-布朗强迫症状清单(Yale-Brown Obsessive Compulsive Scale Symptoms Checklist,Y-BOCS-SC)、强迫信念体验问卷修订版(Obsessive Belief Questionnaire,OBQ-44)、贝克焦虑量表(Beck Anxiety Inventory,BAI)、贝克抑郁自评量表(Beck Depression Inventory,BDI)分别评估被试的强迫症状严重程度及类型、强迫信念和焦虑、抑郁情绪。采用方差分析比较强迫症未治疗组、强迫症已治疗组和健康对照组之间不恰当感的差异。采用Pearson相关分析探索强迫症患者不恰当感和临床症状的相关性,分析不恰当感与强迫症发病过程中强迫症状变化的中介效应模型。对入组时未接受治疗的36例强迫症患者进行为期8周的治疗随访,再次评估强迫症状严重程度和不恰当感及焦虑、抑郁情绪,分析治疗对不恰当感的影响。结果在不恰当感检出率方面,强迫症未治疗组(87.5%,35/40)和强迫症已治疗组(96.08%,49/51)与健康对照组(60%,30/50)3组比较差异有统计学意义(χ2=22.82,P<0.01),两两比较显示强迫症未治疗组和强迫症已治疗
Objective To explore the clinical manifestation and characteristics of not just right experiences(NJREs)in Chinese patients with obsessive-compulsive disorder(OCD),and the correlation with obsessive symptoms.The effect of clinical treatment on NJREs was studied.Methods Clinical data were collected from 91 OCD patients in outpatient care at Beijing Anding Hospital,Capital Medical University,from March 2021 to March 2022.Patients were categorized into an untreated OCD group(40 cases,24 males and 16 females,aged 29.3±8.1 years)and a treated OCD group(51 cases,23 males and 28 females,aged 30.5±8.5 years)based on whether they received treatment in the month prior to admission.An age-matched healthy control group(n=50,25 males and 25 females,aged 30.8±8.9 years)was recruited simultaneously.The Not Just Right Experiences-Questionnaire-Revised(NJRE-Q-R)was used to evaluate the characteristics and severity of NJREs.The Yale-Brown Obsessive-Compulsive Scale(Y-BOCS),Yale-Brown Obsessive Compulsive Scale Symptoms Checklist(Y-BOCS-SC),Obsessive Belief Questionnaire(OBQ-44),Beck Anxiety Inventory(BAI)and Beck Depression Inventory(BDI)were used to evaluate the severity and types of obsessive-compulsive symptoms,obsessive-compulsive beliefs,anxiety,and depressive emotions.Analysis of variance was used to compare differences in NJREs among the untreated OCD group,treated OCD group and the healthy controls.Pearson correlation analysis was performed to explore the correlation between NJREs and clinical symptoms in OCD patients,and an intermediate effect model was used to analyze the mediation role of NJREs in the course of OCD.A treatment follow-up was conducted for 36 untreated OCD patients over 8 weeks,reassessing the severity of obsessive-compulsive symptoms and NJREs,as well as anxiety and depressive emotions to analyze the impact of treatment on NJREs.Results The detection rates of NJREs in the untreated OCD group(87.5%)and the treated OCD group(96.8%)were higher than that those in the healthy control group(60%)with the dif
作者
陈达宁
杨祥云
杨丽娟
李占江
Chen Daning;Yang Xiangyun;Yang Lijuan;Li Zhanjiang(The National Clinical Research Center for Mental Disorders&Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing 100069,China;Clinical Psychology Department of the Second People′s Hospital of Guizhou Province)
出处
《中华精神科杂志》
CAS
CSCD
北大核心
2024年第3期155-163,共9页
Chinese Journal of Psychiatry
基金
北京市医院管理局“青苗”计划(QML20181903)
北京市自然科学基金(7222084)。
关键词
强迫性障碍
不恰当感
临床特征
中介效应
Obsessive-compulsive disorder
Not just right experiences
Clinical features
Mediating effects
