早年创伤与强迫症发病的关联研究  

Eraly trauma experience is associated with obsessive-compulsive disorder

作　　者：王雪梅[1] 陈文[1] 王振[2] 肖泽萍[2] 

机构地区：[1]苏州大学附属第一医院精神医学科,苏州215006 [2]上海交通大学医学院附属精神卫生中心心身科,上海20030

出　　处：《中华行为医学与脑科学杂志》2016年第12期1087-1090,共4页Chinese Journal of Behavioral Medicine and Brain Science

摘　　要：目的：比较早发性与晚发性强迫症早年创伤经历差别，并进一步探讨经历早年创伤种类与强迫症发病的相关性。方法对符合DSM-Ⅳ诊断标准的326例强迫症患者以及480例健康对照进行早年创伤问卷简表（ ETI-SF）评估，比较早发性（ n＝138）与晚发性（ n＝188）强迫症早年创伤的差别，并分析早年创伤种类与强迫症发病的关联性。结果与对照组比较，强迫症组早年创伤量表总分更高[（3．90±3．61）分vs （1．88±2．61）分， P＜0．01]，而且四个维度得分也均高于对照组，其中普通创伤为[（0．94±1．17）分vs （0．66±1．09）分， P＜0．01]，躯体创伤为[（1．12±1．38）分vs （0．71±1．23）分， P＝0．001]，情感虐待为[（1．58±1．71）分vs （0．42±1．01）分， P＜0．01]，性创伤为[（0．27±0．59）分vs （0．09±0．36）分， P＝0．001]。与晚发性强迫症比较，早发性强迫症早年创伤量表总分更高[（5．12±3．58）分vs （3．01±3．38）分， P＜0．01]，其中普通创伤[（1．14±1．27）分vs （0．79±1．07）分， P＝0．006]，躯体创伤[（1．49±1．46）分vs （0．85±1．25）分， P＝0．001]，情感虐待[（2．18±1．76）分vs （1．12±1．53）分， P＜0．01]，性创伤[（0．30±0．66）分vs （0．24±0．67）分， P＝0．42]，早发组的量表四个维度与晚发组相比，均差异有统计学意义（除了性创伤P＝0．42，其余各维度均P＜0．01），其中，情感创伤最显著（ t＝5．75， P＜0．01）。在326例强迫症患者中，247例（75．8％）的患者有早年创伤经历，只有79例（24．2％）强迫症患者早年没有经历任何创伤，而对照组有无创伤经历为57．9％比42．1％，差异有统计学意义（χ2＝21．48， P＜0．01）。经历一种创伤的其强迫症患病率为39．1％，2种为61．0％，经历3种创伤的为65．8％，而经历4种及以上创伤的其Objective To compare the difference of early trauma experience between early-onset and late-onset obsessive-compulsive disorder（OCD）,and the kinds of early trauma in the cause of OCD. Methods Three hundred and twenty-six patients with obsessive-compulsive disorder and 480 healthy con-trols were enrolled. Early Trauma Inventory-Short Form （ ETI-SF） was applied to assess the early trauma ex-perience,compare the difference of early trauma experience between early-onset （ n=138） and late-onset （ n=188） OCD,and the kinds of early trauma in the cause of OCD. Results There were significant differences in the early trauma experience between obsessive-compulsive disorder group and control group（（3.90±3.61） vs （1.88±2.61）, P〈0.01）.Scores of physical（（1.12±1.38） vs （0.71±1.23）, P=0.001）,emotional（（1.58± 1.71） vs （0.42±1.01）, P〈0.01）,and sexual abuse（（0.27±0.59） vs （0.09±0.36）, P=0.001）,and a gener-al traumatic experience（（0.94±1.17） vs （0.66±1.09）, P〈0.01） were significant difference between patients and controls. Except sexual abuse（（0.30±0.66） vs （0.24±0.67）, P=0.42）,there were significant differ-ences in the early trauma between early-onset and late-onset OCD（（5.12±3.58） vs （3.01±3.38）, P〈0.01）,especially emotional abuse（（2.18±1.76） vs （1.12±1.53）, P〈0.01）.247（75.8%） OCD patients and 79（57. 9%） healthy controls experienced early trauma（χ2=21.48, P〈0.01）. Experiencing one kind of early trau-ma,the prevalence of OCD was 39.1%,two kind was 61.0%,three kind of early trauma was 65.8%,and ex-periencing four or more kind of early trauma,the prevalence of OCD was up to 84.4%. Conclusion OCD patients have much more early trauma,especially early-onset OCD. Experiencing more kind of early trauma, and the prevalence of OCD higher may associated with the development of obsessive-compulsive disorder. It is important to consider the role of childhood trauma in the prevention and treatm

关 键 词：强迫症 早年创伤 早年创伤问卷简表 

分 类 号：R749.7[医药卫生—神经病学与精神病学]