强迫症伴强迫型人格障碍患者的临床表现

目的 评估强迫型人格障碍（OCPD）在强迫症（OCD）中的发病率,探讨伴OCPD的OCD患者的临床特征.方法 采用DSM-Ⅳ人格障碍临床定式检测手册（SCID-Ⅱ）中有关OCPD的诊断项目对260例OCD患者进行评估,据其是否符合OCPD诊断而将患者分为共病组（OCD＋ OCPD）和非共病组（OCD-OCPD）.对两者的临床特征、焦虑、抑郁水平等进行比较.结果 78例（30％）OCD患者符合OCPD的诊断;共病组有更多的物品污染、囤积以及高道德标准强迫思维和更多的检查、囤积和混合强迫行为等强迫症状,且共病组强迫行为严重程度、抑郁及特质焦虑水平显著高于非共病组,但两组首次出现强迫症状的年龄,有精神疾病家族史的比例以及自知力水平、状态焦虑水平等差异无统计学意义.结论 强迫型人格障碍与强迫症的重叠可能增加了其病理心理的严重程度.

Clinical manifestation of obsessive-compulsive patients comorbid with obsessive-compulsive personality disorder

Objective To evaluate the differences of clinical manifestation between obsessivecompulsive disorder （OCD） patients with or without obsessive-compulsive personality disorder （OCPD）.Methods The related items about OCPD in Structured Clinical Interview for DSM-Ⅳ Personality Disorder （SCID-Ⅱ） and a parcel of scales were administrated to 260 OCD patients.Results 30％ of the OCD patients fulfilled the criteria for OCPD.Compared to OCD-OCPD,those with OCD＋ OCPD have a higher rate of contamination,hoarding,religious obsessions and checking,hoarding and mental compulsions.Individuals with OCD＋ OCPD have significantly higher scores on depression,trait anxiety and OCD severity while OCD with or without OCPD are similar in terms of gender distribution,age at onset of OC symptoms,disease insight and state anxiety.Conclusions Current findings may suggest that OCD patients with OCPD do not have a highly distinct clinical manifestation,but they may represent a marker of severity.