S. Venturello, U. Albert, G. Maina, F. Bogetto, L. Ravizza - Vol. 7, Marzo 2001, num.1
Testo Immagini Bibliografia Summary Riassunto Indice
La stabilità temporale dei
sintomi ossessivo-compulsivi in un campione di pazienti con doc
Time stability of obsessive-compulsive symptoms in a sample of patients
with OCD
Objectives
It is generally accepted that obsessive-compulsive (OC) symptoms tend
to be stable with time; however, few investigations tested this belief. This
study was carried-out to evaluate: 1) whether the expression of obsessive-compulsive
disorder (OCD) varies with age or with duration of illness; 2) whether OC
symptoms vary with time; 3) whether there exist monosymptomatic patients and
if symptoms in such patients are maintained stable with time.
Method
Ninety-four patients with main DSM-IV diagnosis of OCD and a baseline
Y-BOCS score of at least 16 were admitted to the study. All patients were
assessed with a semistructured interview, comprising the Y-BOCS Symptom
Check-List, aimed at collecting data regarding age and clinical picture at
onset, as well as the clinical outcome of the disorder. The sample was subdivided
in sub-groups according to symptom prevalence as related to age range (<30;
31-40; 41-50; >50) and duration of disease (<1; 1-5; 6-10; >10).
To assess the stability of OC symptoms, only patients with duration of ilness
between 1 and 10 years were considered; symptoms were classified as stable
if present both at onset and at present observation, as disappeared if present
only at onset, or new, if it was present only at observation but not at onset.
Statistical analysis has been carried-out using the Chi-square test and analysis
of variance (ANOVA).
Results
No significant difference emerged regarding the prevalence of symptom
categories or the mean number of obsessions or compulsions per patient per
age range. Statistical analysis did not show any differemce related to duration
of disease. Obsessive symptoms presented significant variability with time,
whereas compulsive symptoms appeared to be stable. Overall, 71.7% of the sample
presented a clinical picture (obsessions and compulsions) which was stable
with time. Seventeen patients (18.7%) were monosymptomatic and time-stable.
Conclusions
Our results, in agreement with other recent data, reject the view that
factors linked to age or duration of disease influence symptoms expression
in OCD. In most cases, OCD patients appear to present obsessive-compulsive
symptoms that tend not to change with time. Studies focusing on clinical predictors
of response to treatment are needed to best identifie individually-centred
treatment strategies.