自知力不良型强迫症临床特征对照研究  

A control study of clinical features of obsessive compulsive disorder with poor insight

作　　者：童庆好 张颖[1] 陆振华[1] 

机构地区：[1]六安市第二人民医院,安徽六安237008

出　　处：《临床心身疾病杂志》2009年第4期298-299,共2页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨自知力不良型强迫症患者的临床特征。方法将75例强迫症患者根据自知力的三个维度评分分为研究组（自知力不良型组）22例，对照组（自知力完整组）53例，均常规应用氯米帕明治疗，观察8w。于治疗前采用焦虑自评量表及抑郁自评量表评定两组焦虑抑郁的严重程度，于治疗前及治疗第2w、4w、6w、8w末采用强迫症状量表评定两组患者强迫症状及药物治疗效果。结果治疗前研究组强迫症状量表、焦虑自评量表及抑郁自评量表总分均显著高于对照组（P均〈0．05）。治疗后两组强迫症状量表总分均随着治疗时间的延续呈持续性下降，研究组治疗前及治疗6w、8w末强迫症状量表总分均高于对照组（P〈0．05）。结论自知力不良型强迫症患者焦虑抑郁情绪及强迫症状较严重，对药物治疗反应较差。Objeceive To explore the clinical features of obsessive compulsive disorder with poor insight. Methode 75 patients with obsessive-compulsive disorder （OCD） were divided into research group（poor insight,n=22） and control group（intact insight,n=53） according to three dimension scores of insight, both groups received routine clomipramine treatment for 8 weeks. Anxiety-depression severity were assessed with the Self-rating Anxiety Scale（SAS） and Self-rating Depression Scale（SDS） for both groups before treatment, compulsive symptoms and treatment effectiveness with the YaleBrown Obsessive Compulsive Scale（YBOCS） before treatment and at the end of the 2nd,4th, 6th and 8th week. Results Before treatment, total scores of the YBOCS,SAS and SDS were significantly higher in the research than in the control group（all P〈0.05）. After treatment,the total scores of the YBOCS of both groups lowered continously along with time of therapy lasting,those at pretreatment and the end of the 6th and 8th week were higher in the research than in the control group（P〈0.05）. Conclusion OCD patients with poor insight have more severe anxious-depressive emotion and compulsive symptom and poor response to medication.

关 键 词：强迫症 自知力不良 临床特征 强迫症状量表 焦虑自评量表 抑郁自评量表 

分 类 号：R749[医药卫生—神经病学与精神病学]