强迫症的临床特征与MMPI4年随访研究

Clinical Features and Polyphasic Personality of Obsessive-compulsive Disorder: a 4-year Follow-up Study

ES评分 0

DOI
刊名
Journal of International Psychiatry
年,卷(期) 2020, 47(6)
作者
作者单位

郑州大学第一附属医院 ;

摘要
摘要 目的:随访强迫症4年的临床特征、预后转归及多相人格的变化;分析不同疗效、不同亚型的强迫症与多相人格变化的关系。方法:已完成所需资料基线评定的强迫症患者,共153例,其中男性89例(58.2%),女性64例(41.8%)。(1)采用自制的一般情况调查表收集强迫症的临床特征、治疗过程、预后转归、病程特点等。(2)采用自身前后对照的方法,分析强迫症患者临床症状(YBOCS、HAMA、HAMD、)的变化;分析前后两次多相人格(MMPI)的变化。结果:(1)原入组153人,随访117例,随访率为76.47%。96.7%保持强迫症的诊断。(2)预后良好者约41.9%,33.3%一般,预后较差者占24.8%。持续病程39例(33.3%),发作病程16例(13.7%),波动病程62例(53.0%)。(3)随访时HAMA评分(8.7±4.8)分,HAMD评分(12.0±6.6)分,Y-BOCS评分(16.4±8.4)分,较入组时均明显降低(p<0.01)。(4)两次MMPI测评剖面图编码模式呈2-7-4或7-2-4。前后比较,K、Hy、Hs、Pa因子分明显降低,Re因子分则是增加的,均有显著性差异(p<0.05)。以预后分组MMPI及各临床量表的变化差异显著。结论:强迫症多呈慢性波动或持续病程,预后不乐观。病态人格(MMPI)的改变与预后转归显著相关,验证了心理特征的异常在强迫症的发病中有重要作用。根据MMPI聚类分析,对强迫症提出新的分类方法,可能对强迫症的治疗选择提供依据。
Abstract
Abstract Purpose:The clinical features, prognosis and changes of multiphase personality of OCD were followed up for 4 years. To analyze the relationship between different therapeutic effects, different subtypes of OCD and the change of polyphasic personality.Method:A total of 153 patients with obsessive-compulsive disorder who completed the baseline assessment of the required data, including 89 males (58.2%) and 64 females (41.8%). (1) A self-made questionnaire was used to collect the clinical characteristics, treatment process, prognosis and course of disease of OCD. (2)The changes of clinical symptoms (YBOCS, HAMA, HAMD,) of patients with OCD were analyzed by self before and after control; The changes of MMPI were analyzed before and after treatment.Result:(1) The original group was 153, and 117 patients were followed up. The follow-up rate was 76.47%. 96.7% maintain diagnosis of obsessive-compulsive disorder. (2) About 41.9% had good prognosis, 33.3% had general prognosis, and 24.8% had poor prognosis. The duration of disease was 39 (33.3%), the duration of attack was 16 (13.7%), and the duration of fluctuation was 62 (53.0%). (3)During follow-up the HAMA score (8.7±4.8), the HAMD score (12.0±6.6), and the Y-BOCS score (16.4±8.4) were significantly lower than those at the time of enrollment (p<0.01). (4) The coding mode of the two MMPI assessment profiles is 2-7-4 or 7-2-4. Before and after comparison, the K, Hy, Hs, and Pa factor scores were significantly decreased, and the Re factor scores were increased, with significant differences (p<0.05). Significant differences in MMPI and clinical scales by prognosis.[Conclusion] Obsessive-compulsive disorder usually presents a chronic fluctuating course or a continuous course, and the prognosis is not optimistic. The change of morbid personality disorder (MMPI) is significantly correlated with prognosis, which proves that the abnormality of psychological characteristics plays an important role in the pathogenesis of OCD. According to MMPI clustering analysis, a new classification method for OCD was proposed, which may provide a basis for treatment selection of OCD.
基金项目
页码 1153-1156
  • 参考文献
  • 相关文献
  • 引用本文

郭慧荣*. 强迫症的临床特征与MMPI4年随访研究 [J]. 国际精神病学杂志. 2020; 47; (6). 1153 - 1156.

  • 文献评论

相关学者

相关机构