Journal of Obsessive-Compulsive and Related Disorders最新文献_第2页

Symptom dimensions of pediatric obsessive-compulsive Disorder: Exploratory examination of associations with clinical features and response to cognitive-behavioral therapy 儿童强迫症的症状维度：与临床特征和对认知行为治疗反应的探索性检查

IF 1.9 4区医学 Q3 PSYCHIATRY

Journal of Obsessive-Compulsive and Related Disorders

Pub Date : 2025-07-01 DOI: 10.1016/j.jocrd.2025.100969

Samuel D. Spencer , Caitlin M. Pinciotti , Jessica D. Leuchter , Anna K. Young , Catherine E. Rast , Andrew G. Guzick , Brent J. Small , Wayne K. Goodman , Joseph F. McGuire , Sabine Wilhelm , Daniel Geller , Eric A. Storch

Several overarching symptom dimensions have been identified within pediatric obsessive-compulsive disorder (OCD), including doubting, obsessing, washing, ordering, neutralizing, and hoarding. These unique symptom presentations may have important clinical implications, especially in terms of potentially distinct associations with age, functional impairment, insight, family accommodation, and symptoms of anxiety and depression. Such symptom dimensions may also differ in their responsiveness to cognitive-behavioral therapy (CBT). Existing literature on the features associated with, and the clinical impact of, OCD dimensions has primarily focused on adults and has often employed measures that make standardized categorization of OCD dimensions across studies more challenging. In the present exploratory study, we examined the clinical features and treatment outcomes associated with different OCD symptom dimensions measured by the Obsessive-Compulsive Inventory-Children's Version (OCI-CV) using data from a previously completed clinical trial. A secondary analysis of data collected from 161 primarily White/non-Hispanic youth (M_age = 12.19) enrolled in a randomized control trial of d-cycloserine-augmented CBT with exposure and response prevention revealed differential relations between clinical features and OCD symptom dimensions at baseline, particularly related to doubting symptoms which were associated with all measured clinical features except insight. However, the rate of improvement in OCD symptom severity during CBT did not differ as a function of OCD symptom dimension. The present study provides evidence that youth can benefit from CBT despite differences in clinical features associated with OCD symptom dimensions. Findings suggest that mental health providers can deliver idiographically tailored gold standard CBT flexibly to youth regardless of OCD symptom dimensionality.

在儿童强迫症（OCD）中，已经确定了几个主要的症状维度，包括怀疑、强迫、洗涤、排序、中和和囤积。这些独特的症状表现可能具有重要的临床意义，特别是在与年龄、功能障碍、洞察力、家庭住宿以及焦虑和抑郁症状的潜在独特关联方面。这些症状维度也可能在他们对认知行为疗法（CBT）的反应上有所不同。现有的关于强迫症维度的特征和临床影响的文献主要集中在成年人身上，并且经常采用的方法使强迫症维度的标准化分类在研究中更具挑战性。在本探索性研究中，我们使用先前完成的临床试验的数据，检查了强迫症儿童版强迫症量表（OCI-CV）测量的不同强迫症症状维度的临床特征和治疗结果。对161名主要为白人/非西班牙裔青年（Mage = 12.19）的数据进行了二次分析，这些数据参加了一项d-环丝氨酸增强CBT暴露和反应预防的随机对照试验，结果显示临床特征和强迫症症状维度在基线时存在差异，特别是与怀疑症状相关的差异，这些症状与所有测量的临床特征相关，除了洞察力。然而，在CBT期间，强迫症症状严重程度的改善率作为强迫症症状维度的函数没有差异。本研究提供的证据表明，尽管与强迫症症状维度相关的临床特征存在差异，但青少年可以从CBT中获益。研究结果表明，无论强迫症症状维度如何，心理健康提供者都可以灵活地为青少年提供个性化定制的金标准CBT。

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引用次数: 0

Treating disgust in obsessive-compulsive disorder: Clinician perspectives in a survey study 治疗强迫症中的厌恶：一项调查研究中的临床医生观点

IF 1.9 4区医学 Q3 PSYCHIATRY

Journal of Obsessive-Compulsive and Related Disorders

Pub Date : 2025-07-01 DOI: 10.1016/j.jocrd.2025.100970

Rachel A. Schwartz , Madeline Hartig , Martin E. Franklin

Exposure plus response prevention (ERP) emphasizes fear-reduction strategies, yet many patients have OCD symptoms driven by emotions other than fear—particularly disgust. Although disgust OCD appears to be associated with worse treatment outcomes, ERP might be modified to enhance fit with disgust-based pathology. It remains unknown how clinicians modify ERP for this presentation in practice and to what effect. In this study, 90 mental health clinicians from diverse professional backgrounds completed an online survey assessing their experiences and perceptions applying ERP with disgust OCD. Participants generally viewed ERP to be effective for disgust OCD. Of 25 tailoring strategies surveyed (derived from the empirical literature and authors’ own clinical experiences), most strategies were used commonly and rated as at least “fairly helpful” for both adults and youth. Among the most frequently used ERP modifications were informal functional assessment, emphasizing tolerating discomfort, designing exposures that elicit disgust, and additional acceptance and mindfulness techniques. Neither ERP nor disgust OCD expertise was related to the total number of tailoring strategies endorsed, the endorsement of any given strategy, or the perceived effectiveness of ERP for disgust; however, expertise was related to the perceived helpfulness of 12 tailoring strategies. In addition, 8 novel ERP tailoring strategies were identified from open-ended response items. Results support the view that ERP can be tailored to treat disgust symptoms and highlight the relevance of evaluative conditioning, inhibitory learning, and cognitive-behavioral interventions traditionally less emphasized in ERP. Findings will inform the development of the first comprehensive protocol for disgust OCD. 249/250 words.

暴露加反应预防（ERP）强调减少恐惧的策略，然而许多患者的强迫症症状是由恐惧以外的情绪驱动的，尤其是厌恶。尽管厌恶性强迫症似乎与较差的治疗结果有关，但ERP可能被修改以增强与基于厌恶的病理的契合。目前尚不清楚临床医生如何修改ERP在实践中的表现和什么效果。在这项研究中，来自不同专业背景的90名心理健康临床医生完成了一项在线调查，评估了他们在厌恶强迫症中应用ERP的经历和感知。参与者普遍认为ERP对厌恶性强迫症有效。在调查的25种定制策略中（来自经验文献和作者自己的临床经验），大多数策略被普遍使用，并且对成年人和青少年至少“相当有帮助”。最常用的ERP修改是非正式的功能评估，强调容忍不适，设计引起厌恶的暴露，以及额外的接受和正念技术。ERP和厌恶强迫症专业知识都与认可的剪裁策略总数、任何给定策略的认可或厌恶ERP的感知有效性无关；然而，专业知识与12种剪裁策略的感知有用性有关。此外，从开放式回答项目中发现了8种新的ERP定制策略。研究结果支持了ERP可以用于治疗厌恶症状的观点，并强调了评价条件反射、抑制性学习和认知行为干预的相关性，这些在ERP中通常不被重视。研究结果将为厌恶性强迫症的第一个综合方案的制定提供信息。249/250单词。

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引用次数: 0

Cultural Variability in predictors of mental contamination: A comparison of Turkish and American samples 精神污染预测因素中的文化差异：土耳其和美国样本的比较

IF 1.9 4区医学 Q3 PSYCHIATRY

Journal of Obsessive-Compulsive and Related Disorders

Pub Date : 2025-07-01 DOI: 10.1016/j.jocrd.2025.100971

Mujgan Inozu , Nicholas S. Myers , Elif Uzumcu , Ozlem Ergin-Ayan , Elif Usta , Yasemin Erol , Emily K. Juel , Joseph B. Friedman , Jonathan S. Abramowitz

Mental contamination (MC) involves feelings of dirtiness arising from internal stimuli rather than external stimuli. While cognitive models of contamination fear may apply to MC, its unique features—such as moral elements, diffuse dirtiness, and limited relief after washing—warrant further study. Cross-cultural variability in cognitive factors also remains underexplored. This study examined cognitive factors (i.e., obsessive beliefs, inferential confusion, fear of self, and scrupulosity) in MC among U.S. and Turkish students, aiming to identify shared and distinct processes. A total of 397 U.S. undergraduates and 461 Turkish undergraduates completed self-report questionnaires of MC, other obsessive-compulsive symptom and cognition domains, and general distress. Turkish students reported higher contact contamination, while U.S. students had higher MC. Turkish participants also showed greater Fear of God-related scrupulosity and inferential confusion. Regression analysis revealed that several factors consistently predicted MC across both cultural groups: general distress, contact contamination severity, fear of self, and overestimation of threat. Other predictors varied by culture: inferential confusion and the fear of God were uniquely associated with mental contamination in U.S. students, while fear of sin was a significant predictor only among Turkish students. These findings may reflect differences in cultural context (including prevalent religious doctrine) between U.S. and Turkish cultures.

心理污染（MC）涉及由内部刺激而非外部刺激引起的肮脏感觉。虽然污染恐惧的认知模型可能适用于MC，但其独特的特征——如道德因素、扩散污垢和洗涤后的有限救济——值得进一步研究。认知因素的跨文化差异也有待进一步研究。本研究考察了美国和土耳其学生在MC中的认知因素（即强迫性信念、推理混乱、自我恐惧和谨慎），旨在确定共同的和不同的过程。共有397名美国大学生和461名土耳其大学生完成了MC、其他强迫症状和认知领域以及一般痛苦的自我报告问卷。土耳其学生报告了更高的接触污染，而美国学生则有更高的MC。土耳其参与者也表现出更大的对与上帝有关的严谨和推理混乱的恐惧。回归分析显示，在两个文化群体中，有几个因素一致地预测了MC：普遍的痛苦、接触污染的严重程度、自我恐惧和对威胁的高估。其他预测因素因文化而异：推理混乱和对上帝的恐惧与美国学生的精神污染有独特的联系，而对罪的恐惧仅在土耳其学生中是一个重要的预测因素。这些发现可能反映了美国和土耳其文化在文化背景（包括流行的宗教教义）上的差异。

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引用次数: 0

Neurocognitive indices of response inhibition within Autogenous and Reactive Obsessions: A brief review 自体和反应性强迫中反应抑制的神经认知指标：简要综述

IF 1.9 4区医学 Q3 PSYCHIATRY

Journal of Obsessive-Compulsive and Related Disorders

Pub Date : 2025-06-22 DOI: 10.1016/j.jocrd.2025.100968

Zachary T. Gemelli, Henry D. Berger, Han-Joo Lee

Obsessive-compulsive disorder (OCD) is a heterogenous and debilitating condition in which roughly half of patients show limited long-term improvement. Improving our understanding on its heterogeneity may help optimize and enhance overall treatment outcomes of OCD. Among various subtyping approaches that currently exist for OCD the Autogenous-Reactive Obsession (AO-RO) subtyping taxonomy has continued to demonstrate high validity with empirical support in clinical and non-clinical samples. Furthermore, growing evidence indicates distinct neurocognitive profiles for AO and RO across studies and neuroimaging modalities within response inhibition indices. Specifically, results demonstrate AO is primarily characterized by deficits in cognitive inhibition, whereas some evidence suggests RO may be primarily characterized by deficits in behavioral inhibition. This article reviews the neurocognitive profiles of AO and RO and discusses the potential clinical utility of understanding their neurocognitive indices in improving treatment outcome for OCD.

强迫症（OCD）是一种异质性和衰弱性疾病，大约一半的患者表现出有限的长期改善。提高我们对其异质性的理解可能有助于优化和提高强迫症的整体治疗效果。在目前存在的各种强迫症亚型方法中，自体反应性强迫症（AO-RO）亚型分类法在临床和非临床样本中继续显示出高度的有效性。此外，越来越多的证据表明，在反应抑制指数的研究和神经成像模式中，AO和RO的神经认知特征不同。具体而言，结果表明AO主要以认知抑制缺陷为特征，而一些证据表明RO可能主要以行为抑制缺陷为特征。本文综述了AO和RO的神经认知特征，并讨论了了解它们的神经认知指标在改善强迫症治疗效果方面的潜在临床应用。

引用次数: 0

A cognitive intervention for negative beliefs about losing control: impact on other cognitive domains and OCD symptoms 对失去控制的消极信念的认知干预：对其他认知领域和强迫症症状的影响

IF 1.9 4区医学 Q3 PSYCHIATRY

Journal of Obsessive-Compulsive and Related Disorders

Pub Date : 2025-06-12 DOI: 10.1016/j.jocrd.2025.100966

Andrea Sandstrom, Adam S. Radomsky

Purpose

Beliefs about losing control have been proposed as a novel cognitive domain in OCD. Despite increasing evidence that links these beliefs with OCD symptoms, it is unclear whether interventions targeting beliefs about losing control lead to symptom improvement. This study sought to develop and test the impact of a brief cognitive intervention for beliefs about losing control on OCD-relevant appraisals and symptoms in a sub-clinical OCD sample.

Methods

A total of 35 sub-clinical participants were recruited based on self-reported OCD symptoms and beliefs about losing control, and randomly assigned to receive a 1-h CBT session targeting beliefs about losing control (intervention) or sleep hygiene (control). Beliefs about losing control, and OCD symptom were assessed at baseline and one week after the intervention using self-report questionnaires. Appraisals of losing control and OCD-relevant appraisals were also assessed using daily monitoring forms during the two-week intervention period.

Results

There was a significant interaction between condition and time on appraisals of losing control and OCD-relevant appraisals measured by the daily monitoring forms, with those in the intervention condition showing greater reductions from baseline to follow-up compared to those in control condition. There were no significant interaction effects on beliefs about losing control or OCD symptoms measured using standardized self-report questionnaires.

Conclusions

These results suggest that incorporating strategies targeting beliefs about losing control into CBT for OCD may be warranted, however more time and/or sessions is/are likely required to achieve broader symptom improvement.

目的失控信念是强迫症的一个新的认知领域。尽管越来越多的证据表明这些信念与强迫症症状有关，但目前尚不清楚针对失去控制信念的干预措施是否会导致症状改善。本研究旨在开发和测试在亚临床强迫症样本中，对失去控制信念进行短暂认知干预对强迫症相关评估和症状的影响。方法根据自我报告的强迫症症状和失去控制信念招募35名亚临床参与者，随机分组接受1小时针对失去控制信念（干预）或睡眠卫生（控制）的CBT治疗。在基线和干预后一周使用自我报告问卷评估失去控制的信念和强迫症症状。在为期两周的干预期间，还使用每日监测表格评估失控和强迫症相关评估。结果用日常监测表测量的失控和强迫症相关评价在条件和时间上存在显著的交互作用，干预组与对照组相比，从基线到随访的下降幅度更大。使用标准化的自我报告问卷对失去控制或强迫症症状的信念没有显著的相互作用。这些结果表明，将针对失去控制信念的策略纳入强迫症的CBT治疗可能是合理的，然而，可能需要更多的时间和/或疗程来实现更广泛的症状改善。

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引用次数: 0

Seeing beyond the diagnostic and statistical manual: A function-centered review of obsessive-compulsive disorder and anxiety disorders 超越诊断和统计手册：强迫症和焦虑症的功能为中心的回顾

IF 1.9 4区医学 Q3 PSYCHIATRY

Journal of Obsessive-Compulsive and Related Disorders

Pub Date : 2025-06-10 DOI: 10.1016/j.jocrd.2025.100967

Jón Ingi Hlynsson , Jan Bergström , Per Carlbring

Obsessive-compulsive disorder (OCD) is classified within its own diagnostic category, separate from anxiety disorders, yet clinical practitioners still treat it as an anxiety disorder; both conceptually and therapeutically. This paper examines the rationale for seperating OCD from the anxiety disorders by contrasting cognitive models of anxiety disorders and OCD, and reviewing phenomenological and psychobiological evidence for OCD's distinctiveness. We compare OCD's behavioral functions with those of specific phobia, panic disorder, agoraphobia, social anxiety disorder, generalized anxiety disorder, and health anxiety disorder. Our review finds no compelling evidence that OCD differs sufficiently from anxiety disorders to warrant its own category. The same functional behaviors are evident in OCD and other anxiety disorders, with the foci of threat being the differentiating factor between disorders (e.g., fear of public speaking vs. fear of contamination in social anxiety and contamination-OCD, respectively). Consequently, we conclude by emphasizing that future research should focus on behavioral function when studying mental disorders, since descriptive similarities may not indicate clinical or functional equivalence. For diagnostic manuals to maintain validity and clinical utility, they must incorporate a functional analytic perspective. Failure to do so may result in inadequate diagnostic categories and stagnant treatment advances (cf. clinical guidelines for OCD have remained unchanged since 2005). While diagnostic manuals are meant to guide treatment selection, descriptive diagnoses need complementary theory-driven case conceptualizations to advance our understanding of maintaining factors and mechanisms of change during treatment. Without this approach, theoretical progress in OCD may stall, ultimately affecting patient outcomes.

强迫症（OCD）有自己的诊断类别，与焦虑症分开，但临床医生仍将其视为焦虑症；无论是概念上还是治疗上。本文通过对比焦虑障碍和强迫症的认知模型，探讨了将强迫症与焦虑障碍区分开来的基本原理，并回顾了强迫症的独特性的现象学和心理生物学证据。我们将强迫症的行为功能与特定恐惧症、惊恐障碍、广场恐怖症、社交焦虑障碍、广泛性焦虑障碍和健康焦虑障碍的行为功能进行比较。我们的研究没有发现令人信服的证据表明强迫症与焦虑症有足够的区别，因此不能单独归类。同样的功能行为在强迫症和其他焦虑障碍中也很明显，威胁焦点是疾病之间的区分因素（例如，社交焦虑和污染-强迫症分别是对公共演讲的恐惧和对污染的恐惧）。因此，我们的结论是强调未来的研究应该集中在研究精神障碍时的行为功能，因为描述性的相似性可能并不表明临床或功能等效。为了保持诊断手册的有效性和临床效用，它们必须包含功能分析的观点。如果不这样做，可能会导致诊断类别不充分，治疗进展停滞不前（参见强迫症临床指南自2005年以来一直保持不变）。虽然诊断手册旨在指导治疗选择，但描述性诊断需要补充理论驱动的病例概念，以促进我们对治疗过程中维持变化的因素和机制的理解。如果没有这种方法，强迫症的理论进展可能会停滞，最终影响患者的治疗结果。

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引用次数: 0

Psychometric evaluation of the Indonesian Yale–Brown Obsessive-Compulsive Scale—Second Edition 印尼耶鲁-布朗强迫症量表第二版的心理测量评估

IF 1.9 4区医学 Q3 PSYCHIATRY

Journal of Obsessive-Compulsive and Related Disorders

Pub Date : 2025-06-06 DOI: 10.1016/j.jocrd.2025.100965

Riangga Novrianto , Christiana L. Ticoalu , P. Tommy Y.S. Suyasa , Steffi Hartanto , Wayne K. Goodman , Eric A. Storch , Edo S. Jaya

The Yale-Brown Obsessive-Compulsive Scale Second Edition (Y-BOCS-II) is the gold-standard measure of obsessive-compulsive disorder (OCD) severity, yet no validated Indonesian version exists. This study evaluated the psychometric properties of the Indonesian Y-BOCS-II in 141 adult outpatients with OCD. The Y-BOCS-II demonstrated excellent internal consistency (KR-20 = 0.90 for Symptom Checklist and ω = 0.94 for Severity Scale), strong inter-rater reliability (ICC = 0.99), and high temporal stability over two weeks (ICC = 0.90). Confirmatory factor analyses revealed poor fit for both the original obsession/compulsion and alternative interference/control two-factor models. However, three-factor model (Time/Frequency, Resistance/Control, Distress/Interference) demonstrated acceptable fit (RMSEA = 0.09, CFI = 0.97, SRMR = 0.04). The scale demonstrated convergent validity with the Obsessive-Compulsive Inventory-Revised and Florida Obsessive-Compulsive Inventory Severity Scale, while maintaining discriminant validity from Patient Health Questionnaire - 9 and Generalized Anxiety Disorder - 7. These findings establish the Indonesian Y-BOCS-II as a reliable and valid measure for assessing OCD symptoms in Indonesian clinical settings and suggest presence of a three-factor conceptualization of OCD symptomatology.

耶鲁-布朗强迫症量表第二版（Y-BOCS-II）是衡量强迫症（OCD）严重程度的黄金标准，但目前还没有经过验证的印尼版本。本研究评估了141例成年强迫症门诊患者印尼Y-BOCS-II的心理测量特征。Y-BOCS-II表现出优异的内部一致性（症状检查表的r- 20 = 0.90，严重性量表的ω = 0.94），较强的评分间信度（ICC = 0.99），以及两周内较高的时间稳定性（ICC = 0.90）。验证性因子分析显示，原始的痴迷/强迫和替代的干扰/控制双因素模型都不适合。然而，三因素模型（时间/频率，阻力/控制，困扰/干扰）显示出可接受的拟合（RMSEA = 0.09, CFI = 0.97, SRMR = 0.04）。该量表与《强迫量表修订版》和《佛罗里达强迫量表严重程度量表》具有趋同效度，同时与《患者健康问卷- 9》和《广泛性焦虑障碍量表》- 7保持区别效度。这些发现确立了印尼Y-BOCS-II作为评估印尼临床环境中强迫症症状的可靠和有效的测量方法，并提示存在强迫症症状学的三因素概念化。

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引用次数: 0

Compulsions in trauma-exposed patients with obsessive-compulsive disorder: Differences in prevalence and impact on treatment response 创伤暴露强迫症患者的强迫行为：患病率差异及其对治疗反应的影响

IF 1.9 4区医学 Q3 PSYCHIATRY

Journal of Obsessive-Compulsive and Related Disorders

Pub Date : 2025-06-02 DOI: 10.1016/j.jocrd.2025.100964

Caitlin M. Pinciotti , Gregor Horvath , Matti Cervin

The effectiveness of exposure and response prevention (ERP), a front-line treatment for obsessive-compulsive disorder (OCD), is contingent on reducing engagement in compulsions, though recent research has found that certain compulsions may be less amenable to ERP. Given the impact of trauma exposure on OCD compulsions, the present study sought to examine whether compulsion-specific differences in treatment response may be attributable to trauma exposure. Using a sample of 622 patients diagnosed with OCD receiving intensive treatment (39.7 % trauma-exposed), certain compulsions were found to be more prevalent among trauma-exposed patients and differentially impacted treatment effectiveness. Trauma-exposed patients were more likely to engage in reassurance, rumination, and hair pulling, and less likely to engage in self-assurance compulsions compared to non-trauma exposed patients. Interestingly, among trauma-exposed patients, engaging in self-assurance compulsions was associated with better treatment outcomes and engaging in reassurance compulsions was associated with worsened treatment outcomes. Findings converge with trauma-focused treatment approaches, wherein functional self-assurance is not only permitted but encouraged. Although historically any form of assurance in ERP is discouraged, clinicians treating trauma-exposed patients with OCD may consider leveraging engagement in non-compulsive self-assurance to increase self-efficacy and treatment motivation and challenge distorted trauma-related beliefs. Findings highlight the importance of considering with nuance the function of underlying behaviors.

暴露和反应预防（ERP）是强迫症（OCD）的一线治疗方法，其有效性取决于减少对强迫行为的参与，尽管最近的研究发现，某些强迫行为可能不太适合ERP。鉴于创伤暴露对强迫症强迫的影响，本研究试图检验治疗反应的强迫特异性差异是否可归因于创伤暴露。对622名接受强化治疗的强迫症患者（39.7%为创伤暴露患者）进行抽样调查，发现某些强迫行为在创伤暴露患者中更为普遍，并对治疗效果产生不同程度的影响。与非创伤暴露的患者相比，创伤暴露的患者更有可能进行安慰、沉思和拔头发，而不太可能进行自我保证强迫症。有趣的是，在创伤暴露的患者中，参与自我保证的强迫行为与更好的治疗结果相关，参与安慰的强迫行为与更糟糕的治疗结果相关。研究结果与以创伤为中心的治疗方法一致，其中功能自我保证不仅允许而且鼓励。虽然历史上任何形式的自我保证都是不被鼓励的，但临床医生治疗创伤暴露的强迫症患者可能会考虑利用非强迫性自我保证来提高自我效能和治疗动机，并挑战扭曲的创伤相关信念。研究结果强调了以细微差别考虑潜在行为功能的重要性。

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引用次数: 0

The prevalence of aggressive obsessions in youth with obsessive-compulsive disorder: A meta-analysis 青少年强迫症患者中攻击性强迫症的患病率：一项荟萃分析

IF 1.9 4区医学 Q3 PSYCHIATRY

Journal of Obsessive-Compulsive and Related Disorders

Pub Date : 2025-05-29 DOI: 10.1016/j.jocrd.2025.100963

Olivia C. Bishop , Brooke Hiscock , Quinn Morris , Chelsea Lahey , Charlotte Corran , Sandra Krause , Jonathan M. Fawcett , Emily J. Fawcett

Despite obsessive-compulsive disorder (OCD) being a recognizable psychiatric disorder, certain presentations of OCD are still highly stigmatized and misidentified by healthcare professionals. Namely, aggressive obsessions, which include ego-dystonic, intrusive thoughts and fears of accidentally or intentionally harming the self or others, are vastly under researched. With current prevalence estimates for aggressive obsessions in pediatric OCD ranging anywhere from 30.8 % to 86 %, the primary aim of the current meta-analysis was to provide the first meta-analytic estimate of the worldwide prevalence of aggressive obsessions among youth with OCD. A secondary goal of this study was to quantify sources of heterogeneity that contribute to the variability in prevalence estimates to date. A systematic review was conducted in Covidence using the following online databases: PsycINFO, PubMed, and CINAHL. Of the 4218 articles imported and screened, 831 received a full-text review, with 27 studies (N = 3428) ultimately coded. Using a random-effects model, the aggregate lifetime prevalence rate of aggressive obsessions was found to be 65.1 % CI_95 % [57.3 %, 72.2 %], with prediction intervals ranging from 43.9 % to 81.7 %, and a current prevalence rate of 61.9 % CI_95 % [56.4 %, 67.0 %], with prediction intervals ranging from 37.0 % to 81.8 %. The presence of comorbidities and the type of diagnostic measure utilized were found to be significant moderators for current estimates. With over half of youth experiencing aggressive obsessions in their lifetime, continuing education is required for healthcare professionals to be able to identify and properly treat this common, but often overlooked, symptom dimension.

尽管强迫症（OCD）是一种公认的精神疾病，但强迫症的某些表现仍然被医疗专业人员高度污名化和错误识别。也就是说，攻击性强迫症，包括自我失调、侵入性思想和对意外或故意伤害自己或他人的恐惧，目前还没有得到充分的研究。目前小儿强迫症中攻击性强迫症的患病率估计在30.8%到86%之间，本荟萃分析的主要目的是提供全球青少年强迫症中攻击性强迫症患病率的第一个荟萃分析估计。本研究的第二个目标是量化迄今为止导致患病率估计变异性的异质性来源。使用以下在线数据库：PsycINFO、PubMed和CINAHL在《covid》中进行了系统评价。在导入和筛选的4218篇文章中，831篇获得了全文综述，其中27篇研究（N = 3428）最终被编码。采用随机效应模型，发现攻击强迫症的总终生患病率为65.1% ~ 95%[57.3%,72.2%]，预测区间为43.9% ~ 81.7%；当前患病率为61.9% ~ 95%[56.4%,67.0%]，预测区间为37.0% ~ 81.8%。发现合并症的存在和使用的诊断措施类型是当前估计的重要调节因素。超过一半的青少年在其一生中经历过攻击性强迫症，医疗保健专业人员需要继续接受教育，以便能够识别和正确治疗这种常见但经常被忽视的症状维度。

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引用次数: 0

Identity – OCD 身份-强迫症

IF 1.9 4区医学 Q3 PSYCHIATRY

Journal of Obsessive-Compulsive and Related Disorders

Pub Date : 2025-05-29 DOI: 10.1016/j.jocrd.2025.100962

Jeffrey M. Cohen , Brian A. Feinstein , Caitlin M. Pinciotti

引用次数: 0