• 제목/요약/키워드: Obsessive-compulsive symptom

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강박장애 환자에서의 성격 5요인 모델 분석 (Analysis of the Five-Factor Model of Personality in Obsessive-Compulsive Disorder)

  • 허민정;변민수;김성년;김의태;장준환;권준수
    • 대한불안의학회지
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    • 제8권2호
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    • pp.99-105
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    • 2012
  • Objective : The aim of this study is to evaluate the five-factor model of personality in patients with obsessive-compulsive disorder (OCD) related to obsessive-compulsive symptom severity and the distinct symptom subgroups. Methods : We recruited 95 patients with OCD and 116 normal controls in the study. We used the short version of Revised NEO Personality Inventory and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) for the assessment. Results : Patients with OCD showed significantly higher scores in neuroticism than normal controls. On multiple linear regression analysis, we found that agreeableness and conscientiousness were associated with the total Y-BOCS scores. On subscale analysis, agreeableness and neuroticism were associated with the obsession subscale scores and only conscientiousness was associated with the compulsion subscale scores. Furthermore, we found that patients who have contamination/cleaning or symmetry/ordering/counting/arranging as a main symptom presentation had significantly higher mean scores in conscientiousness than patients who have harm due to injury/violence/aggression as a main symptom presentation. Conclusion : In this study, we found that specific personality factors are associated with the obsessive-compulsive symptom severity. In addition, this is the first study to investigate the relationship between the personality factors in the five-factor model and the distinct symptom subgroups in OCD.

강박장애의 개념과 진단기준의 변천과 향후 방향 (Concept, Diagnostic Criteria and a Future Prospective of Obsessive-Compulsive Disorder)

  • 노대영;김지민;김찬형
    • 대한불안의학회지
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    • 제6권2호
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    • pp.93-101
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    • 2010
  • Research on obsessive-compulsive disorder (OCD) has advanced substantially since the DSM-IV was published in 1994. It is time to reexamine the nosology of this disorder, reviewing conflicting views regarding the classification as well as subtypes and specifiers of OCD. Although there is ongoing debate, OCD experts have suggested that OCD be retained in the section related to anxiety disorders and also that along with OCD, this section include obsessive-compulsive spectrum disorders (OCSD), a group of disorders closely related to OCD. A combined 'anxiety and obsessive-compulsive spectrum chapter' has also been proposed to include OCSDs. A growing body of scientific data has provided empirical support for the inclusion of a 'tic-related' subtype of OCD in the DSM-V. However, it remains controversial as to whether to introduce OCD symptom dimensions as specifiers as well as items in the diagnostic criteria. With regard to compulsive hoarding, there has been sufficient evidence to recommend that it be classified in the DSM-V as a separate disorder. Much work remains in order to ensure that the DSM-V is as evidence based as possible. It is necessary to strive toward integrating the biological and psychological data related to OCD and OCSD based on their endophenotypic features.

강박장애 환자에서 강박증상차원에 부합하는 12문항 강박증상목록의 심리측정적 특성 (Psychometric Properties of the Korean Version of 12-Item Obsessive-Compulsive Inventory in Accordance With Obsessive-Compulsive Symptom Dimensions in Individuals With Obsessive-Compulsive Disorder)

  • 서호석;최미나;이승재
    • 대한불안의학회지
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    • 제19권1호
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    • pp.10-18
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    • 2023
  • Objective : The 18-item Obsessive-Compulsive Inventory-Revised (OCI-R) is widely employed to assess symptoms of obsessive-compulsive disorder (OCD). However, this instrument's factor structure does not align with contemporary dimensional models of OCD. Therefore, the objective of this study was to examine psychometric properties of the 12-item Korean OCI (OCI-12) on four obsessive-compulsive symptom dimensions, in patients with OCD. Methods : A total of 157 patients with OCD and 51 healthy controls completed psychological measures, including the OCI-R, Dimensional Obsessive-Compulsive Scale (DOCS), and scales evaluating anxiety and depressive symptoms. Pychometric characteristics of the OCI-12 with three neutralizing and three hoarding items eliminated from the OCI-R, were analyzed. Results : All OCI-12 items registered excellent internal consistency at 0.83. Confirmatory factor analysis revealed strong association between individual items and their proposed latent factors (i.e., subscales). Convergent validity was appropriate. A high correlation was particularly observed for the DOCS score (r=0.71, p<0 .001). Moreover, the OCI-12 was as sensitive as the OCI-R for determining effects of empirically supported treatment for OCD. Conclusion : The OCI-12 is a 12-item measure that adheres to the prevailing 4-factor model of OCD dimensions. Like OCI-R, it possesses good to excellent psychometric properties, including reliability, validity, and sensitivity to treatment.

EQ-5D를 이용한 강박장애 환자의 삶의 질과 증상 중증도의 연관성 연구 (Association between Quality of Life and Symptom Severity in Obsessive-Compulsive Disorder Patients Using EQ-5D)

  • 김성년;문우리;한재욱;이준희
    • 생물정신의학
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    • 제24권3호
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    • pp.129-133
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    • 2017
  • Objectives Obsessive-compulsive disorder (OCD) is a disabling psychiatric disorder, and more attention is recently paid on the quality of life (QoL) in OCD patients. The Euro-QoL-5D (EQ-5D) is a widely used self-report to calculate a single score which represents 'health utilities'. The aim of this study was to assess the health-related QoL for patients with OCD using the EQ-5D and to examine the relationship between health-related QoL and symptom severity. Methods Seventy-three patients with a Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of OCD were recruited from the outpatient clinic in Seoul National University Hospital. Symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and QoL was assessed with the EQ-5D-5L questionnaire. Using Korean valuation study, a single score of QoL was calculated. Results Most of the OCD patients were relatively young (< 45 years) with the mean YBOCS total score of 19.33. The mean EQ-5D score was 0.71 and significantly correlated with symptom severity (r = -0.483, p < 0.001). 25% of the EQ-5D score was predicted by the YBOCS total score (b = -0.011, p < 0.001) by regression analysis. Conclusions OCD patients suffer from lower health-related QoL and QoL significantly decreased as symptom severity increased. The results of the EQ-5D would enable further studies on QoL comparison across medical disease and mental disorders.

Voxel-Based Morphometry Study of Gray Matter Abnormalities in Neurodegenerative Disease with Obsessive-Compulsive Behaviors

  • Lee, Kang Joon;Miller, Bruce L.
    • 정신신체의학
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    • 제22권2호
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    • pp.130-137
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    • 2014
  • Objectives : Obsessive-compulsive(OC) symptoms have yet to be directly studied in neurodegenerative conditions involving behavioral changes. To examine regional abnormalities in the brains of dementia patients with OC symptoms, we assessed the gray matter density using voxel-based morphometry(VBM). Methods : We performed brain magnetic resonance imaging(MRI) with VBM analysis in 106 dementia patients with OC behaviors. In this study, OC behaviors were investigated in patients with neurodegenerative disease using the modified Manchester Behavior Questionnaire. Results : The OC behavior scores were correlated with structural brain volume using VBM. The total OC symptom score correlated negatively with the volume of both putamens, the right middle orbitofrontal gyrus, both anterior cingulate cortices, and the left insula(p<0.001, uncorrected). No gray matter reductions were associated specifically with the OC symptom sub-categories. Conclusions : Our results suggest that abnormalities in these brain regions may play an important role in the pathophysiology of OCD in neurodegenerative disease. This is the first lesion study to investigate the neural basis of OCD behaviors in neurodegenerative disease.

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고등학생의 정신건강 상태에 관한 연구 -SCL-90을 이용, 서울시 인문계 1 . 3학년을 중심으로- (A STUDY ON MENTAL HEALTH STATE OF HIGH SCHOOL STUDENTS)

  • 김은주
    • 보건교육건강증진학회지
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    • 제5권2호
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    • pp.110-141
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    • 1988
  • This study was conducted to find out the mental health state of high school students. First-year students and third-year students af liberal high schools is Seoul were subject to this study. Questionnaire of Symptom Checklist-90 and various factors was adopted for the survey. A total of 916 questionnaires was sellected for the analysis, and the results are obtained as follows; 1) The characteristics in responses to mental health scale showed that obsessive-compulsive scale score was the highest, followed by interpersonal-sensitivity, depression, hostility, and anxiety. The subject group of the students showed higher scores in nine symptom dimensions except somatization than other normal group. 2) Girl-students showed higher scores than boy-students in somatization, depression, and anxiety, whereas the opposite was true in hostility. 3) Third-year students got high scores, in somatization, anxiety and Depression. 4) Parental marriage state of the repondents showed significant differences in nine symptom dimensions of mental health. Scores of the students with parents was the lowest, followed by those of students with only mother, only father and the rest(no parents, divorced, sepaerated, step-parent) in increasing order. 5) Smoking students showed high score in obsessive-compulsive, depression, hostility, paranoid ideation, and psychoticism. Especially in hostility, they got much higher score. 6) Students with poor record at school got higher scores in every symptom dimension than those with good record at school, especially in obsessive-compulsive and depression scale. 7) Parents' attitude toward student showed significant effect on every scale. Students under over-expectation or indifference from parents were in bad mental health state. 8) Students who have advisor proved to be in better mental health state than those who never consult their personal problems with others. 9) He who has family history got higher scores in some scales. 10) Respondents who looked upon what they have learned in high school as being rather an obstacle to sound social life got high scores in all the symptom dimensions and next came those of the students who answered that there were a lot of unnecessary things in their learning. 11) Those for whom it would not quite necessary to enter college if there were little formal schooling discrimination in society got high scores in obsessive-compulsive, interpersonal sensitivity, depression, hostility, and in psychoticism, especially higher in obsessive-compulsive scale. 12) Mental health state of the students who are influenced by the social surroundings, mass media, and the home environments showed high score in 8 symptom dimensions. 13) Abnormal response frequency of this sample is as follows; 24.0% of boys, 23.8% of girls, 22.5% of the first-year students, and 26.9% of the third-year students. There were significant difference among the grades. 14) The factors of distinctive correlation between the dimensions of SCL-90 and 16 factors were the father's negative attitude and depression, negative responses on teaching contents and anxiety, and smoking and hostility. In conclusion, mental health state of liberal highschool students on the whole showed worse than other normal groups. It had close terms with relation with their parents, schoolwork, smoking, teaching contents, the social surrounding, mass media, and the home environments. Thus I believe there need not only mental health education of students, training of teachers, counceling of parents, but also changes in teaching contents, and the improvement of educational system and the social surroundings under the national support.

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중학교 일학년 학생에서 모즐리 강박척도를 이용한 탐색적 요인 분석 (Exploratory Factor Analysis of the Maudsley Obsessive-Compulsive Inventory in Middle School Students)

  • 박경혜;김효원;김진영;정인원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제22권2호
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    • pp.89-94
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    • 2011
  • Objectives : The purpose of this study was to assess the factor structures related to the Maudsley Obsessive-Compulsive Inventory (MOCI) in middle school students. Methods : A total of 1,175 7th grade students from four middle schools in Paju city completed the MOCI, Center for Epidemiological Studies-Depression scale (CES-D), and Self Esteem Scale (SES). An exploratory factor (maximum likelihood method with oblique rotation) and correlation analyses were subsequently performed. Results : The two main factors related to the MOCI were 'intrusive thought' and 'contamination'. 'Intrusive thought' was positively correlated with the CES-D and negatively associated with the SES. 'Contamination' had a negative correlation with self-esteem as measured by the SES. Conclusion : The results of this study revealed a two-factor structure of obsessive and compulsive symptoms in middle school students.

안정화된 만성 조현병 환자에서 강박장애 증상이 삶의 질에 미치는 영향 (Impact of Comorbid Obsessive Compulsive Symptoms on Quality of Life in Stable Patients with Chronic Schizophrenia)

  • 문정윤;강석훈;석정호;김찬형;김태용;최진희;소형석
    • 대한불안의학회지
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    • 제13권2호
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    • pp.141-147
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    • 2017
  • Objective : This study aimed to evaluate the relationship between comorbid obsessive compulsive disorder (OCD) and quality of life in stable patients with schizophrenia. Methods : We interviewed 162 symptom-stable inpatients who have been on a constant dose of antipsychotics for at least 3 months prior and diagnosed as chronic schizophrenia. Subsequently, patients were classified according to the existence of OCD as evaluated using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Further, all clinical and demographic data were collected and evaluated. To investigate potential interrelationships, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Korea-Positive and Negative Symptom Scale (K-PANSS), Korean Modification of the Scale to Measure Subjective Well-Being under Neuroleptic Treatment (KmSWN) and Korean Version Quality of Life Scale (K-QOLS) were performed. Independent t-test and Chi-square test were used to compare groups and regression analysis was done to assess the relationship between the Y-BOCS and quality of life. Results : Schizophrenia patients with OCD showed significantly earlier onset of schizophrenia, more severe psychiatric symptoms and lower quality of life, compared to those without comorbid OCD. OCD might be associated with lower quality of life in schizophrenia. Conclusion : Schizophrenia patients with OCD showed lower quality of life than those without OCD. In the treatment for schizophrenia, evaluation of OCD might be needed to improve their quality of life and social function.

안정화된 만성 정신분열병 환자에서 강박장애 동반과 사회적 기능 (Comorbid Obsessive Compulsive Disorder and Social Function in Stable Patients with Chronic Schizophrenia)

  • 강석훈;석정호;김찬형;김윤중;김형주;최종혁
    • 대한불안의학회지
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    • 제7권1호
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    • pp.40-47
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    • 2011
  • 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 ttest 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.

좌측 정중 전두엽과 양측 기저절 경색 후 과잉성욕 증상과 강박 증상을 보인 환자 1례 (A Case Report : Hypersexuality and Obsessive-Compulsive Behaviors in a Stroke Patient with the Left Mesial Frontal Cortex and Both Basal Ganglia Lesion)

  • 김세주;김영신;최낙경;이병철;이만홍
    • 생물정신의학
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    • 제8권2호
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    • pp.271-275
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    • 2001
  • 60세 남자 환자로 좌측 정중 전두엽과 양측 기저절 경색 후 발생한 과잉성욕 증상과 강박 증상을 주소로 내원하였다. 환자는 뇌졸중 후에 발생한 운동 기능 장애는 시간이 경과하면서 호전되어 발병 1개월 이내에 거의 정상화된 반면 과잉성욕 증상과 강박 증상은 호전되지 않았다. 환자에게 과잉성욕 증상과 강박 증상을 목표로 fluvoxamine과 perphenazine을 처방하였으며 치료 시작 후 2개월이 경과하면서 환자의 과잉성욕 증상과 강박 증상은 서서히 사라졌다. 이 증례는 기저절-시상전두엽 회로가 성적 행동과 강박 증상의 조절에 있어 중요한 역할을 하고 있음을 시사한다고 할 수 있다. 과잉성욕 증상은 임상에서 간과하기 쉽고 또한 일반적으로 성적 활동에 대한 변화는 환자들 스스로 보고하지 않는 경향이 많다. 따라서 뇌졸중 환자, 특히 정중 전두엽이나 기저절 병변을 동반한 환자들의 경우에는 비록 그 병변이 측두엽 침범이 없거나 Kluver-Bucy syndrome의 전형적인 증상을 보이지 않는다 할 지라도 성욕등 성적 활동에 대한 체계적인 조사가 필요할 것으로 생각된다. 또한 과잉성욕 증상과 강박 증상을 함께 가지고 있는 경우 선택적인 세로토닌 재흡수 억제제의 사용이 두 증상 모두를 효과적으로 치료하는 데에 도움이 될 수 있을 것이다.

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