强迫症患者临床特征及预后转归的影响因素分析  

Clinical characteristics of obsessive-compulsive disorder and the influencing factors of prognosis

作　　者：郭慧荣[1] 黄百灵 王亚丽[1] 张延妍 马全刚 GUO Huirong;HUANG Bailing;WANG Yali;ZHANG Yanyan;MA Quangang(Department of Psychiatry,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第一附属医院精神医学科,河南郑州450052

出　　处：《新乡医学院学报》2020年第5期475-480,共6页Journal of Xinxiang Medical University

基　　金：河南省科技厅基金资助项目(编号:172102310578)。

摘　　要：目的分析强迫症患者的临床特征、预后转归及影响治疗效果的因素。方法选择2014年1月至2015年6月于郑州大学第一附属医院精神医学科就诊的强迫症患者153例为研究对象。患者病程发展4 a后进行随访,并采用自制的一般情况调查表收集强迫症患者的临床特征、治疗过程、预后转归、病程特点等;采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、Yale-Brown强迫量表(Y-BOCS)评估患者的临床症状,并根据Y-BOCS的2个分量表Yale-Brown强迫思维量表(Y-BOS)、Yale-Brown强迫动作量表(Y-BCS)评分将患者分为强迫思维组(n=37)、强迫动作组(n=14)和混合组(n=66),根据Y-BOCS评分降分率评估3组患者的治疗效果;采用Spearman′s非参数相关、偏相关分析患者的疗效与临床特征的相关性;分析影响治疗效果的因素。结果153例患者中,117例(76.47%)获得随访。男性患者的年龄小于女性患者(P<0.05),男性和女性患者婚姻状况比较差异有统计学意义(P<0.05),男性患者发病年龄早于女性患者(P<0.01)。117例患者中71例(60.7%)患者发病前有一定社会心理因素,46例(39.3%)患者发病前无明显诱因;持续治疗者50例(42.7%),间断治疗者65例(55.6%),2例(1.7%)未进行过任何治疗。男性和女性患者延迟治疗时间比较差异无统计学意义(P>0.05)。强迫思维组、强迫动作组、混合组患者年龄分布、教育年限、延迟治疗时间、病程、性别、婚姻、诱因、治疗方法、治疗形式、HAMA、HAMD评分及临床疗效等方面比较差异均无统计学意义(P>0.05);强迫思维组患者平均发病年龄早于强迫动作组和混合组(P<0.01),强迫动作组和混合组患者发病年龄比较差异无统计学意义(P>0.05);3组患者病程形式比较差异有统计学意义(P<0.05);强迫动作组、混合组患者Y-BOCS评分高于强迫思维组(P<0.05),强迫动作组和混合组患者Y-BOCS评分比较差异无统计学意义(P>0.05)。117例�Objective To analyse the clinical characteristics and prognosis and the influencing factors of therapeutic effect of patients with obsessive-compulsive disorder(OCD).Methods One hundred and fifty-three patients with OCD admitted to the Department of Psychiatry of the First Affiliated Hospital of Zhengzhou University were selected as the study objects.The patients were followed-up after four years;at the same time,the clinical characteristics,treatment process,prognosis and course characteristics of patients were collected by self-made general information questionnaire.The clinical symptoms of patients were evaluated by hamilton depression scale(HAMD),hamilton anxiety scale(HAMA),Yale-Brown obsessive compulsive scale(Y-BOCS);and the patients were divided into compulsive thinking group(n=37),compulsive action group(n=14)and mixed group(n=66)according to the scores of two subscales of Y-BOCS of Yale-Brown obsessive scale(Y-BOS)and Yale-Brown compulsive scale(Y-BCS);the treatment effect of patients in the three groups was evaluated by reduction rate of Y-BOCS score.The correlation between the therapeutic effect and clinical characteristics was analysed by Spearman′s nonparametric correlation and partial correlation.Results One hundred and seventeen(76.47%)of 153 patients were followed up.The age of male patients was lower than that of female patients(P<0.05);There was significant difference in the marriage status between the male and female patients(P<0.05);the average age of onset of male patients was earlier than that of female patients(P<0.01).Among the 117 patients,71(60.7%)patients had certain social and psychological factors before onset,46(39.3%)patients had no obvious inducement before onset;50(42.7%)patients received continuous treatment,65(55.6%)patients received intermittent treatment,and 2(1.7%)patients not received any treatment.There was no significant difference in delayed treatment time between male and female patients(P>0.05).There was no significant difference in age distribution,education years,d

关 键 词：强迫症 随访 病程转归 预后 

分 类 号：R749.3[医药卫生—神经病学与精神病学]