强迫症患者的强迫信念和冲动特质对症状维度的影响

doi:10.3969/j.issn.1674-8115.2021.06.008

摘要/Abstract

摘要：

目的·讨论不同强迫信念和冲动特质与强迫症不同症状亚型间的关系。方法·纳入未服用或停用2个月以上抗强迫药物的强迫症患者139例和健康对照110名，使用耶鲁布朗强迫量表（Yale-Brown Obsessive Compulsive Scale，Y-BOCS）、强迫信念问卷-44（Obsessive Beliefs Questionnaire-44，OBQ-44）、Barratt冲动性量表（Barratt Impulsiveness Scale，BIS-11）和强迫症状分类量表修订版（Obsessive Compulsive Inventory-Revised，OCI-R）分别评估其症状严重程度、强迫信念程度、冲动特质及症状维度。采用多元线性回归分析评估强迫症患者的强迫信念与冲动特质对强迫症症状维度的影响。结果·强迫症患者的各临床量表分数都显著高于健康对照组（均P<0.05）。强迫检查水平（或严重度）受责任感/威胁评估（responsibility/threat estimate，RT）信念和运动冲动（motor impulsiveness，MI）的共同影响（B=0.053，P=0. 000；B=-2.000，P=0.011）；强迫排序水平受完美主义/确定感（perfectionism/certainty，PC）信念影响显著（B=0.049，P=0.001）；强迫思维水平受RT信念的影响（B=0.082，P=0.000）；混合型症状水平受RT信念和注意冲动（cognitive impulsiveness，CI）的共同影响（B=0.038，P=0.006；B=0.248，P=0.044）。结论·具有不同强迫信念和冲动特质的强迫症患者会呈现不同症状亚型。

关键词: 强迫症状, 强迫信念, 冲动特质

Abstract:

Objective·To test the effects of obsessive beliefs and impulsivity traits on different subtypes of obsessive-compulsive (OCD).

Methods·A total of 139 non-medicated OCD patients and 110 matched healthy controls (HCs) were enrolled. The clinical symptoms were evaluated separately using Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Obsessive Beliefs Questionnaire-44 (OBQ-44), Barratt Impulsiveness Scale (BIS-11), and Obsessive Compulsive Inventory-Revised (OCI-R). Multiple linear regression analysis was used to evaluate the influence of obsessive beliefs and impulsive traits on symptom dimensions of obsessive-compulsive disorder.

Results·The scores of all clinical scales of OCD patients were significantly higher than those of HCs (P<0.05). Obtained by multiple regression, the checking score was affected by responsibility/threat estimate (RT) and motor impulsiveness (MI) (B=0.053, P=0.00; B=-2.000, P=0.011); the ordering score was significantly affected by the perfectionism/certainty (PC) belief (B=0.049, P=0.001); the score of obsessing was affected by the belief in RT (B=0.082, P=0.000); the neutralizing score was affected by both RT belief and cognitive impulsiveness (CI) (B=0.038, P=0.006; B=0.248, P=0.044).

Conclusion·OCD patients with different obsessive-compulsive beliefs and impulsivity traits will conduct different symptoms.

Key words: obsessive-compulsive symptoms, obsessive beliefs, impulsivity traits

中图分类号:

R749.7

李璞玉, 程佳月, 顾秋梦, 阮瀚阳, 王勇, 刘强, 吴艳茹, 王振. 强迫症患者的强迫信念和冲动特质对症状维度的影响[J]. 上海交通大学学报(医学版), 2021, 41(6): 756-760.

Pu-yu LI, Jia-yue CHENG, Qiu-meng GU, Han-yang RUAN, Yong WANG, Qiang LIU, Yan-ru WU, Zhen WANG. Influence of obsessive beliefs and impulsivity traits on symptom dimensions of obsessive-compulsive disorder patients[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(6): 756-760.

图/表 2

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Item	Obsessive-compulsive disorder group (n=139)	Healthy group (n=110)	P value
Age/year	30.2±8.0	29.4±7.32	0.397
Gender/n(%)			0.698
Male	83 (59.7)	63 (57.3)
Female	56 (40.3)	47 (42.7)
Marriage/n(%)			0.362
Single	85 (61.2)	76 (69.1)
Married	51 (36.7)	31 (28.2)
Divorced	3 (2.1)	3 (2.7)
Education/year	14.0±3.0	14.1±2.7	0.712
Y-BOCS/score	24.7±5.2	?	?
OBQ-44/score	184.3±44.7	147.3±40.3	0.000
RT	71.6±18.8	56.1±16.2	0.000
PC	70.1±18.7	56.9±16.0	0.000
ICT	42.5±13.6	34.3±11.1	0.000
BIS-11/score	59 (56, 61)	61 (58, 63)	0.001
MI	19 (17, 21)	21 (19, 22.3)	0.000
CI	14 (13, 15)	13 (12, 14)	0.009
NI	26 (24, 27)	27 (25, 28)	0.001
OCI-R/score	25 (15, 34)	6 (3, 11.25)	0.000
Washing	5 (2, 9)	1 (0, 2)	0.000
Checking	4 (2, 6)	1 (1, 3)	0.000
Ordering	4 (2, 6)	1 (0, 3)	0.000
Hoarding	2 (1, 4)	1 (0, 3)	0.002
Obsessing	6 (4, 9)	0 (0, 2)	0.000
Neutralizing	3 (1, 5)	1 (0, 2)	0.000

Item	Obsessive-compulsive disorder group (n=139)	Healthy group (n=110)	P value
Age/year	30.2±8.0	29.4±7.32	0.397
Gender/n(%)			0.698
Male	83 (59.7)	63 (57.3)
Female	56 (40.3)	47 (42.7)
Marriage/n(%)			0.362
Single	85 (61.2)	76 (69.1)
Married	51 (36.7)	31 (28.2)
Divorced	3 (2.1)	3 (2.7)
Education/year	14.0±3.0	14.1±2.7	0.712
Y-BOCS/score	24.7±5.2	?	?
OBQ-44/score	184.3±44.7	147.3±40.3	0.000
RT	71.6±18.8	56.1±16.2	0.000
PC	70.1±18.7	56.9±16.0	0.000
ICT	42.5±13.6	34.3±11.1	0.000
BIS-11/score	59 (56, 61)	61 (58, 63)	0.001
MI	19 (17, 21)	21 (19, 22.3)	0.000
CI	14 (13, 15)	13 (12, 14)	0.009
NI	26 (24, 27)	27 (25, 28)	0.001
OCI-R/score	25 (15, 34)	6 (3, 11.25)	0.000
Washing	5 (2, 9)	1 (0, 2)	0.000
Checking	4 (2, 6)	1 (1, 3)	0.000
Ordering	4 (2, 6)	1 (0, 3)	0.000
Hoarding	2 (1, 4)	1 (0, 3)	0.002
Obsessing	6 (4, 9)	0 (0, 2)	0.000
Neutralizing	3 (1, 5)	1 (0, 2)	0.000

OCI-R index	OBQ-44/BIS-11	B	SE	β	t	P
Checking	RT	0.053	0.013	0.321	4.011	0.000
Checking	MI	-2.000	0.077	-0.208	-2.593	0.011
Ordering	PC	0.049	0.014	0.287	3.546	0.001
Obsessing	RT	0.082	0.013	0.488	6.468	0.000
Neutralizing	RT	0.038	0.014	0.234	2.819	0.006
Neutralizing	CI	0.248	0.122	0.168	2.031	0.044

OCI-R index	OBQ-44/BIS-11	B	SE	β	t	P
Checking	RT	0.053	0.013	0.321	4.011	0.000
Checking	MI	-2.000	0.077	-0.208	-2.593	0.011
Ordering	PC	0.049	0.014	0.287	3.546	0.001
Obsessing	RT	0.082	0.013	0.488	6.468	0.000
Neutralizing	RT	0.038	0.014	0.234	2.819	0.006
Neutralizing	CI	0.248	0.122	0.168	2.031	0.044

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