본문 바로가기
KERD
논문KCI 등재

안정화된 만성 정신분열병 환자에서 강박장애 동반과 사회적 기능

Comorbid Obsessive Compulsive Disorder and Social Function in Stable Patients with Chronic Schizophrenia

석정호|최종혁|김형주|김윤중|김찬형|강석훈
대한불안의학회 (Korean Academy of Anxiety Disorders)|2011.04|대한불안의학회지 (Anxiety and Mood)|제7권 제1호|pp. 40-47

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

만성분열병·강박장애·사회적 기능.Chronic schizophrenia·Obsessive compulsive-disorder·Social function.
주제분류정신과학

초록

Objective : This study aimed to investigate the prevalence of obsessive-compulsive disorder (OCD) in schizophrenia, and the relationship among OCD, severity of psychopathology, and social function in stable patients with chronic schizophrenia. Methods : We interviewed 138 symptom-stable inpatients who had been on a constant dose of antipsychotics for at least 1 month prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as investigated using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Further, all clinical and demographic data was investigated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), and the Korean Personal and Social Performance (K-PSP) were used. An independent t-test and Chi-square test were used to compare groups and a Pearson’s correlation coefficient was used to assess the relationship between the Y-BOCS and other clinical rating scales. Results : The prevalence of OCD in schizophrenia patients was 18.1%. Patients with schizophrenia and OCD exhibited significantly earlier onset of schizophrenia, more severe psychiatric symptoms, and lower personal and social performance ability as compared to those without OCD. There was no significant relationship among Y-BOCS, K-PANSS, and K-PSP. Conclusion : We found that comorbid OCD was relatively more frequent in patients with schizophrenia. An investigation involving larger samples of schizophrenia patients with OCD with respect to social function and thus, the effect on quality of life is required. (Anxiety and Mood 2011;7(1):40-47)

Abstract

Objective : This study aimed to investigate the prevalence of obsessive-compulsive disorder (OCD) in schizophrenia, and the relationship among OCD, severity of psychopathology, and social function in stable patients with chronic schizophrenia. Methods : We interviewed 138 symptom-stable inpatients who had been on a constant dose of antipsychotics for at least 1 month prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as investigated using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Further, all clinical and demographic data was investigated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), and the Korean Personal and Social Performance (K-PSP) were used. An independent t-test and Chi-square test were used to compare groups and a Pearson’s correlation coefficient was used to assess the relationship between the Y-BOCS and other clinical rating scales. Results : The prevalence of OCD in schizophrenia patients was 18.1%. Patients with schizophrenia and OCD exhibited significantly earlier onset of schizophrenia, more severe psychiatric symptoms, and lower personal and social performance ability as compared to those without OCD. There was no significant relationship among Y-BOCS, K-PANSS, and K-PSP. Conclusion : We found that comorbid OCD was relatively more frequent in patients with schizophrenia. An investigation involving larger samples of schizophrenia patients with OCD with respect to social function and thus, the effect on quality of life is required. (Anxiety and Mood 2011;7(1):40-47)

참고문헌 (47)

  1. Rosen I, "The clinical significance of obsessions in schizophrenia", J Ment Sci, 103, pp.773~785 (1957)
  2. Tibbo P, "Obsessive-compulsive disorder in schizophrenia", J Psychiatr Res, 34, pp.139~146 (2000)
  3. Berman I, "Obsessive and compulsive symptoms in chronic schizophrenia", Compr Psychiatry, 36, pp.6~10 (1995)
  4. Samuels J, "Personality disorders and normal personality dimensions in obsessive-compulsive disorder", Br J Psychiatry, 177, pp.457~462 (2000)
  5. Lysaker PH, "Patterns of obsessive-compulsive symptoms and social function in schizophrenia", Psychiatry Res, 125, pp.139~146 (2004)
  6. Fenton WS, "The prognostic significance of obsessive-compulsive symptoms in schizophrenia", Am J Psychiatry, 143, pp.437~441 (1986)
  7. Swedo SE, "Obsessive-compulsive disorder in children and adolescents. Clinical phenomenology of 70 consecutive cases", Arch Gen Psychiatry, 46, pp.335~341 (1989)
  8. American Psychiatric Association, "Diagnostic criteria from DSM-IV-TR" (2000), American Psychiatric Association
  9. 한오수, "DSM-IV의 제 1축 장애의 구조화된 임상적 면담. SCID-I 연구용 판", 하나의학사
  10. Poyurovsky M, "Obsessive-compulsive disorder in patients with first-episode schizophrenia", Am J Psychiatry, 156, pp.1998~2000 (1999)
  11. Rapaport MH, "Quality-of-life impairment in depressive and anxiety disorders", Am J Psychiatry, 162, pp.1171~1178 (2005)
  12. Gladis MM, "Quality of life: expanding the scope of clinical significance", J Consult Clin Psychol, 67, pp.320~331 (1999)
  13. Mendlowicz MV, "Quality of life in individuals with anxiety disorders", Am J Psychiatry, 157, pp.669~682 (2000)
  14. Hwang MY, "Clinical and neuropsychological profiles of obsessive-compulsive schizophrenia: a pilot study", J Neuropsychiatry Clin Neurosci, 12, pp.91~94 (2000)
  15. 김찬형, "강박증상이 동반된 정신분열병 환자의 임상적 특성", 대한정신약물학회지, 14(3), pp.292~298 (2003), 대한정신약물학회
  16. Rasmussen SA, "The epidemiology and clinical features of obsessive compulsive disorder", Psychiatr Clin North Am, 15, pp.743~758 (1992)
  17. Tibbo P, "Prevalence and relationship to delusions and hallucinations of anxiety disorders in schizophrenia", Depress Anxiety, 17, pp.65~72 (2003)
  18. Bland RC, "Schizophrenia: lifetime co-morbidity in a community sample", Acta Psychiatr Scand, 75, pp.383~391 (1987)
  19. Buckley PF, "Psychiatric comorbidities and schizophrenia", Schizophr Bull, 35, pp.383~402 (2009)
  20. 이중서, "한국판 양성 및 음성증후군 척도(Positive and Negative Syndrome Scale)의 신뢰도와 타당도", 신경정신의학, 40(6), pp.1090~1105 (2001), 대한신경정신의학회
  21. Guy W, "Clinical global impression National Institute of Mental Health", 217~221 (1976)
  22. Goodman WK, "The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability", Arch Gen Psychiatry, 46, pp.1006~1011 (1989)
  23. 이정구, "한국판 Personal and Social Performance 척도 (K-PSP)의 표준화 연구", 대한정신약물학회지, 17(6), pp.497~506 (2006), 대한정신약물학회
  24. Kay SR, "The positive and negative syndrome scale (PANSS) for schizophrenia", Schizophr Bull, 13, pp.261~276 (1987)
  25. Morosini PL, "Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning", Acta Psychiatr Scand, 101, pp.323~329 (2000)
  26. Karno M, "The epidemiology of obsessive-compulsive disorder in five US communities", Arch Gen Psychiatry, 45, pp.1094~1099 (1988)
  27. 정신질환실태 역학 조사, "국립서울정신병원", 68~ (2001)
  28. Meghani SR, "Schizophrenia patients with and without OCD", Paper presented at: 151st Annual Meeting of the American Psychiatric Association (1998)
  29. 이명지, "정신분열병 환자에서의 강박증상에 관한 연구： 발생 빈도, 임상 특성 및 삶의 질", Korean J Schizophr Res, 11, pp.26~30 (2008)
  30. Owashi T, "Obsessive-compulsive disorder and obsessive-compulsive symptoms in Japanese inpatients with chronic schizophrenia - A possible schizophrenic subtype", Psychiatry Res (2010)
  31. Cassano GB, "Occurrence and clinical correlates of psychiatric comorbidity in patients with psychotic disorders", J Clin Psychiatry, 59, pp.60~68 (1998)
  32. Ohta M, "Features of obsessive-compulsive disorder in patients primarily diagnosed with schizophrenia", Psychiatry Clin Neurosci, 57, pp.67~74 (2003)
  33. Lykouras L, "Olanzapine and obsessive-compulsive symptoms", Eur Neuropsychopharmacol, 10, pp.385~387 (2000)
  34. Patil VJ, "Development of transient obsessive-compulsive symptoms during treatment with clozapine", Am J Psychiatry, 149, pp.272~ (1992)
  35. Baker RW, "Emergence of obsessive compulsive symptoms during treatment with clozapine", J Clin Psychiatry, 53, pp.439~442 (1992)
  36. 이준영, "정신분열병 환자에서 강박증상의 연구:예비적 연구", 신경정신의학, 40(6), pp.1132~1139 (2001), 대한신경정신의학회
  37. Englisch S, "Clozapine-induced obsessive-compulsive syndromes improve in combination with aripiprazole", Clin Neuropharmacol, 32, pp.227~229 (2009)
  38. Hawng MY, "schizophrenia with obsessive-compulsive features", Medscape Mental Health, 2, pp.7~ (1997)
  39. Lysaker PH, "Obsessive and compulsive symptoms in schizophrenia: clinical and neurocognitive correlates", J Nerv Ment Dis, 188, pp.78~83 (2000)
  40. Bradshaw JL, "The neurodevelopmental frontostriatal disorders: evolutionary adaptiveness and anomalous lateralization", Brain Lang, 73, pp.297~320 (2000)
  41. Eisen JL, "Obsessive compulsive disorder with psychotic features", J Clin Psychiatry, 54, pp.373~379 (1993)
  42. Lysaker PH, "Association of obsessions and compulsions in schizophrenia with neurocognition and negative symptoms", J Neuropsychiatry Clin Neurosci, 14, pp.449~453 (2002)
  43. Kruger S, "Prevalence of obsessive-compulsive disorder in schizophrenia and significance of motor symptoms", J Neuropsychiatry Clin Neurosci, 12, pp.16~24 (2000)
  44. Poyurovsky M, "Obsessive-compulsive disorder in elderly schizophrenia patients", J Psychiatr Res, 40, pp.189~191 (2006)
  45. Apter A, "Depression and suicidal behavior in adolescent inpatients with obsessive compulsive disorder", J Affect Disord, 75, pp.181~189 (2003)
  46. Craig T, "Chronic fatigue syndrome: evaluation and treatment", Am Fam Physician, 65, pp.1083~1090 (2002)
  47. Poyurovsky M, "Obsessive-compulsive disorder in hospitalized patients with chronic schizophrenia", Psychiatry Res, 102, pp.49~57 (2001)

관련 논문AI추천

안정화된 만성 조현병 환자에서 강박장애 증상이 삶의 질에 미치는 영향강석훈, 김찬형, 김태용, 문정윤, 석정호, 소형석, 최진희대한불안의학회 · 대한불안의학회지2017 · 제13권 제2호불안장애의 경계：강박장애와 정신분열병김찬형, 임준석대한신경정신의학회 · 신경정신의학2008 · 제47권 제6호조현병 환자의 유병기간에 따른 강박증상김수룡, 김임렬, 백인호, 서주현, 조정민대한생물정신의학회 · 생물정신의학2018 · 제25권 제2호정신분열병 환자에서 강박증상의 연구:예비적 연구강웅구, 김용식, 노명선, 이준영대한신경정신의학회 · 신경정신의학2001 · 제40권 제6호Schizophrenia with Obsessive-Compulsive Features: Review of Clinical and Conceptual IssuesJun Soo Kwon, Michael Y. Hwang, Sun Young Yum대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2009 · 제7권 제1호강박장애 및 아임상형 강박장애의 평생 유병률과 병발성박수빈, 박종익, 배재남, 서동우, 이동우, 이동은, 이준영, 조맹제, 조성진, 함봉진, 홍진표대한불안의학회 · 대한불안의학회지2009 · 제5권 제1호

이 간행물의 다른 논문 (7건)

공황장애의 감정 인식 및 조절 메커니즘이경욱, 김유라pp. 3-8한국판 우울과 신체 증상 평가 척도(Depression and Somatic Symptom Scale, DSSS)의 신뢰도와 타당도최지혜, 홍진표, 박승진, 김건우, 최혜라pp. 9-15불안 장애에서 벡우울척도의 요인구조장은영, 박용천, 한창우, 김대호, 양현주pp. 16-21한국인 일반인구에서의 사회 불안 증상의 특성하주원, 임세원, 오강섭, 강여진pp. 22-28소방공무원의 외상 후 스트레스, 대처방식, 해리 경험의 관계채정호, 김봉명, 반신환pp. 29-33
원문 보기