强迫症患者症状维度的初步研究

目的 探讨强迫症(OCD)患者的症状维度.方法 采用耶鲁-布朗强迫症状维度量表(DY-BOCS)症状清单(医生版)对139例强迫症患者的症状进行评估.结果 半数患者有1个症状维度(50.4%);有2个及3个维度的患者比例依次为24.5%和14.4%;有4～7个维度的患者则较少(5.8%、3.6%、0.7%、0.7%).患者最多的症状为对称维度(67.6%),其次为污染维度(43.2%)和伤害维度(31.7%);其他比例较少的维度依次为混合(18.7%)、身体(11.5%)、性/宗教维度(10.8%)和储藏(8.6%)维度.男性出现对称维度的比例为75.8%,显著高于女性(52.1%)(P<0.01);而女性在污染维度上的比例为56.3%,显著高于男性(36.3%)(P<0.05);男性和女性在其他症状维度上差异无显著性.早发型患者在对称维度上的比例要高于晚发型患者,分别为77.6%和60.5%(P<0.05);在其他症状维度上二者无显著性差异.结论 初步研究结果提示强迫症患者的症状维度有可能为划分疾病亚型提供依据.

Preliminary study of symptom dimensions in chinese patients with obsessive-compulsive disorder

Objective To study the symptom dimensions of Chinese patients with obsessive-compulsive disorder(OCD). Methods Symptom checklist in expert versions of Dimensional Yale-Brown Obsessive-Compul-sive Scale (DY-BOCS) was used to assess the symptom dimensions of 139 OCD patients. Results Nearly half of the patients had one dimension (50.4%). The frequency of patients with two or three dimensions was 24.5% and 14.4%. Patients with four to seven dimensions were very few and the frequency were 5.8% ,3.6% ,0.7% and 0.7% ,respectively. The most common symptom dimensions were symmetry (67.6%), contamination (43.2%) and aggressive (31.7%). The frequency of patients with miscellaneous, somatic, sex and religious, hoarding di-mension were 18.7%, 11.5% , 10.8% ,8.6% ,respectively. The frequency of male patients with symmetry dimen-sion was higher than that of the female patients(75.8%/52.1%, P<0.01), and the frequency of female patients with contamination dimension was higher than that of male patients (56.3%/36.3%, P<0.05). There were no differences in other dimensions between male and female patients. The early-onset patients had a greater of symp-toms in the symmetry dimension than late-onset patients and there were no differences between these two groups in other dimensions (77.6% vs 60.5%, P<0.05 ) . Conclusion Preliminary data suggest that the symptom di-mension approach may aid in the identification of subtype of OCD.