强迫症的临床特征及其与人格障碍的共病情况分析

目的:分析强迫症患者的临床特征及其与人格障碍的共病情况。方法:调查强迫症的临床特征,并采用SCID鄄Ⅱ对115例强迫症和100名健康对照者进行人格障碍的评估。结果:多数强迫症患者于25岁之前发病,男性患者的发病明显早于女性(t=2.35,P=0.02),男性患者的强迫动作分量表评分低于女性(t=2.08,P<0.05);强迫症患者中人格障碍的发生率为71.3%,明显高于对照组的7.0%,差异有非常显著性(P<0.01);强迫症患者中有8种人格障碍的发生率显著高于对照组,其中最常见的类型为强迫型(54.8%)、回避型(32.2%)和偏执型(21.7%);聚类分析显示强迫型人格障碍同强迫症存在密切关系。结论:强迫症多起病于25岁之前,不同性别患者的临床特征存在差异;强迫症与人格障碍的共病是一种常见现象,强迫型人格障碍与强迫症存在密切关系,今后在强迫症的临床诊断与治疗以及生物学研究中应考虑人格特质与人格障碍的影响。

Clinical characteristics of obsessive-compulsive disorder and its comorbidity with personality disorders

Objective To evaluate the clinical characteristics of obsessive-compulsive disorder(OCD) and to explore the comorbidity of OCD and personality disorders (PDs). Methods A total of 115 OCD patients and 100 matched normal controls were included in this study. The Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) was employed to evaluate the personality of all the subjects. Results In the male patients with OCD, their mean onset age of OCD was mostly less than 25 years old (t=2.35,P=0.02)and their compulsive scale score was lower(t=2.08,P<0.05)when the compared with the female. There were 71.3% of the OCD patients fulfilled the criteria of PD, with the rate being significant higher than that of normal controls(7.0%, P<0.01). OCD patients had a significant higher frequency of 8 kinds of PDs when comparing with controls, with obsessive-compulsive, avoidant and paranoid PD being the most prevalent ones. The results of clustering analysis suggested that OCD and obsessive-compulsive personality disorder were closely linked. Conclusion Most OCD patients onset occur before the age of 25 with evident differences between male and female in clinical character. The comorbidity of OCD and PDs is a common phenomenon, and there is close relation between obsessive-compulsive personality disorder and OCD. The PDs and personality traits should be considered in the diagnosis, treatment and basic study of OCD.