在OCD和抑郁症共病患者的治疗中,应针对OCD症状抑郁症对强迫症治疗的影响：5年随访的结果解析.docVIP

在OCD和抑郁症共病患者的治疗中，应针对OCD症状 抑郁症对强迫症治疗的影响：5年随访的结果 Gideon E. Anholta,b,*，Idan M. Aderkac，Anton J.L.M. van Balkoma，Johannes H. Smita， Haggai Hermeshd，Els de Haane，Patricia van Oppena 背景：许多OCD患者存在共病，重度抑郁症是最常观察到的共病之一。OCD和抑郁症共病患者表现出功能缺陷和生活质量较差。不过，目前还不清楚抑郁症状是否能预测治疗缓解，关于在共病患者的治疗中是否应该针对这些症状，仍存在争议。本研究的目的是评估在OCD治疗的长期结果中抑郁和OCD症状的预测值。 方法：本研究在一组121例OCD患者（接受了16次行为或认知治疗，单独或同时服用氟伏沙明）中，对OCD和抑郁症状之间的关系进行了系统研究。 结果：在长达5年的随访中，抑郁症（无论是作为一个连续或分类变量）不能预测任何治疗方法的治疗缓解。OCD症状的改变大部分可预测抑郁症状的改变，但反之则不行。 局限性：参与RCT之后，近三分之二的参与者接受了某些形式的其它治疗（无论是药物还是心理）， 因此，无法确定与试验后接受其它治疗之间的相互作用。 结论：OCD和抑郁症共病的治疗应着重改善OCD症状。当OCD治疗成功时，抑郁症状也很有可能得到改善。 关键词：强迫症 抑郁 精神治疗 药物治疗 The impact of depression on the treatment of obsessive–compulsive disorder: Results from a 5-year follow-up Gideon E. Anholta,b,*，Idan M. Aderkac，Anton J.L.M. van Balkoma，Johannes H. Smita， Haggai Hermeshd，Els de Haane，Patricia van Oppena a Department of Psychiatry and Institute for Research in Extramural Medicine, VU-University Medical Center and Academic Outpatient Clinic for Anxiety Disorders,GGZ InGeest, Amsterdam, The Netherlands b Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel c Department of Psychology, Boston University, Boston, MA, USA d Anxiety Disorders and Behavior Therapy Unit, Adult Outpatient Department, Geha Mental Health Center, Petach-Tikva, Israel and the Sackler Faculty of Medicine,Tel-Aviv University, Tel-Aviv, Israel e Academic Medical Centre, Department of Child and Adolescent Psychiatry/ De Bascule, University of Amsterdam, Amsterdam, The Netherlands Background: Many OCD patients present with comorbid conditions, and major depression isone of the most frequent comorbidities observed. OCD patients with comorbid depressionexhibit functional disability and poor quality of life. However, it is unclear whether depressivesymptoms are predictive of treatment response, and debate remains whether they should betargeted in the treatment of comorbid patients. The current study aimed at assessing thepredictive valu