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강박장애의 임상적 특징과 충동성의 관련성

The Relationship Between Clinical Characteristics and Impulsiveness in Obsessive-Compulsive Disorder

김찬형|김세주|노대영
대한신경정신의학회 (Korean Neuropsychiatric Association)|2009.09|신경정신의학 (JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)|제48권 제5호|pp. 336-343

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참고문헌

키워드

충동성·강박장애·저장·증상차원Obsessive-compulsive disorder·Impulsiveness·Hoarding·Symptom dimension
주제분류정신과학

초록

강박장애 환자의 충동성에 대한 기왕의 연구들이 있었으나 결과는 일관되지 않았다. 본 연구 결과 강박장애 환자의 충동성은 정상인보다 전반적으로 높은 편이나, 무계획 충동성에 있어서는 정상인과 차이가 없는 특성을 지닌다. 발달적 접근과 증상차원적 접근을 통해 강박장애를 체계적으로 이해하려는 노력은 비교적 최근에 이루어지기 시작한 편이다. 그 중에 조기발병 강박증과‘저장’ 유형은 그 중에서도 병태생리 및 치료반응의 측면에서 뚜렷이 구별되는 유력한 아형들 중 하나이다. 본 연구에서 충동성이 강박장애 환자의 빠른 발병 연령과‘저장’ 증상차원의 공통적인 특성으로 확인된 바, 강박장애의 아형 분류에 중요한 근거로 이용될 수 있을 것이다. 추후 보다 많은 환자군들을 대상으로 한 전향적 연구와 더불어 신경심리학적 실험 연구와 공존질환에 따른 비교 연구 등 충동성에 대한 다양한 접근이 필요하겠다.

Abstract

Objectives: Previous studies have indicated that obsessive-compulsive disorder (OCD) is associated with high levels of impulsiveness. The aim of this study was to assess whether there are differences in clinical correlates with impulsiveness between OCD patients and healthy controls, and whether there is a significant relation between certain obsessive-compulsive symptomatic dimensions and impulsiveness. Methods: A group of 45 OCD outpatients and 45 matched healthy controls were interviewed and diagnosed according to DSM-IV criteria. All subjects were assessed by means of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Barratt Impulsiveness Scale (BIS-11), the Hamilton Anxiety Scale (HAM-A), and the Montgomery-Asberg Depression Rating Scale (MADRS). Results: Compared with healthy controls, OCD patients exhibited significantly higher BIS-11 scores except for with respect to non-planning impulsiveness. The MADRS scores and age at onset in patients with OCD were significantly correlated with BIS-11 total scores. Multiple regression analyses revealed that only age at onset showed an independent positive correlation with impulsiveness. Hoarding was the only dimension significantly associated with impulsiveness. Conclusion: These findings suggest that groups of patients with early onset OCD may show some association with impulsiveness, and that impulsiveness may be another distinct clinical feature of hoarding in OCD.

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충동성과 강박성: 개념, 관계 및 임상적 함의이훈진, 최혜라한국심리학회 · 한국심리학회지:일반2012 · 제31권 제1호강박성향군의 강박사고 위협자극에 대한 억제기능곽호완, 구본훈, 김지현, 이종환, 장문선한국건강심리학회 · 한국심리학회지: 건강2016 · 제21권 제1호강박장애의 개념과 진단기준의 변천과 향후 방향김지민, 김찬형, 노대영대한불안의학회 · 대한불안의학회지2010 · 제6권 제2호여성 강박장애의 임상적 특성과 치료 전략김찬형, 홍현주대한신경정신의학회 · 신경정신의학2006 · 제45권 제2호강박장애 환자의 반응억제 결함강지인, 김세주, 부영준대한불안의학회 · 대한불안의학회지2015 · 제11권 제1호강박장애의 증상차원과 공존 인격병리의 관련성에 관한 연구윤탁, 권준수, 김명선, 노규식, 하태현대한신경정신의학회 · 신경정신의학2004 · 제43권 제1호

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