Symptom stability in adult obsessive-compulsive disorder: Data from a naturalistic two-year follow-up study

被引:207
作者
Mataix-Cols, D
Rauch, SL
Baer, L
Eisen, JL
Shera, DM
Goodman, WK
Rasmussen, SA
Jenike, MA
机构
[1] Univ London Imperial Coll Sci Technol & Med, Sch Med, Dept Psychiat, Div Neurosci & Psychol Med,Stress Self Help Clin, London W14 9NS, England
[2] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Psychiat, Boston, MA USA
[3] Brown Univ, Sch Med, Dept Psychiat & Human Behav, Butler Hosp, Providence, RI 02912 USA
[4] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA
关键词
D O I
10.1176/appi.ajp.159.2.263
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: Little is known about the longitudinal course of symptoms in adult patients with obsessive-compulsive disorder (OCD), although some evidence exists regarding symptom stability in children and adolescents. This study systematically investigated the temporal stability of individual symptoms and symptom dimensions of OCD in adult patients who were followed prospectively for 2 years. Method: One hundred seventeen adult outpatients with OCD from three U.S. sites were administered the Yale-Brown Obsessive Compulsive Scale symptom checklist four times over a period of 2 years. Eighty-one (69%), 83 (71%), and 67 (57%) patients were available 6 months, 1 year, and 2 years after initial screening, respectively. Different analytic methods assessed the stability of OCD symptoms within and between previously identified symptom dimensions. Results: For the most part, patients maintained their symptoms throughout follow-up, although some symptoms were more stable than others. For the symptoms that changed, changes occurred within rather than between symptom dimensions; qualitative shifts from one dimension to another were rare. The strongest predictor of the presence of a particular symptom was having had that symptom in the past. Although most patients had received pharmacological and behavioral treatment during the follow-up period, changes within symptom dimensions could not be explained by overall clinical improvement over time. Conclusions: Symptoms of adult patients with OCD might be more stable across time than previously thought, with some symptoms waxing and waning within symptom dimensions and rarely involving shifts between dimensions. Longer follow-up studies involving larger samples are needed to better understand the fluctuations of OCD symptoms across time.
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页码:263 / 268
页数:6
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