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首页> 外文期刊>The journal of clinical psychiatry >Clinical predictors of drug nonresponse in obsessive-compulsive disorder.
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Clinical predictors of drug nonresponse in obsessive-compulsive disorder.

机译：强迫症中药物无反应的临床预测指标。

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OBJECTIVE: Obsessive-compulsive disorder (OCD) is often a chronic and disabling illness with high comorbidity. Serotonin reuptake inhibitors (SRIs) are effective in treating OCD. However, 40% to 60% of patients with OCD do not respond adequately to SRIs. This study aims to identify the clinical predictors of nonresponse to SRIs in OCD by comparing SRI responders and nonresponders. METHOD: 122 subjects with a diagnosis of DSM-IV OCD of at least 1 year's duration and with treatment history of adequate trials with at least 2 SRIs were recruited from December 2002 to March 2004. Of these, 67 were SRI responders and 55 were SRI nonresponders; they were compared on various clinical parameters. Nonresponse was defined as a score of >/=3 on the Clinical Global Impressions-Improvement sub-scale (CGI-I) after at least 2 adequate trials with SRIs. Response was defined as a score of 1 or 2 on the CGI-I. RESULTS: In regression analysis, baseline severity of OCD (p = .049), comorbid major depressive disorder (p = .005), presence of sexual obsessions (p = .002), and washing (p = .008) and miscellaneous compulsions (p = .013) were identified as predictors of nonresponse to SRIs. Early age at onset showed a trend toward prediction of nonresponse (p = .056). In the univariate analysis, mixed OCD (p = .001) and poor insight (p = .023) were associated with nonresponse. CONCLUSION: This study has identified clinical predictors of nonresponse to SRIs. These predictors may have to be taken into consideration and assessed carefully when SRIs are prescribed to treat OCD. Future studies should aim at identifying treatment modalities that are effective in SRI nonresponders.
机译：目的：强迫症（OCD）通常是一种慢性并致残性疾病，高合并症。血清素再摄取抑制剂（SRIs）可有效治疗强迫症。但是，有40％至60％的强迫症患者对SRI的反应不足。本研究旨在通过比较SRI应答者和非应答者来确定OCD中对SRI应答无反应的临床预测因素。方法：从2002年12月至2004年3月，招募了122名诊断为DSM-IV OCD至少持续1年且具有至少2个SRI的充分试验治疗史的受试者。其中67名SRI应答者和55名SRI应答者无反应者;他们在各种临床参数上进行了比较。无反应定义为在至少进行2次SRI充分试验后，临床总体印象改善子量表（CGI-1）的得分为> / = 3。响应定义为CGI-1得分为1或2。结果：在回归分析中，强迫症的基线严重程度（p = .049），合并性重度抑郁症（p = .005），性强迫症（p = .002）以及洗手（p = .008）和其他强迫症（p = .013）被确定为对SRI无反应的预测因子。发病的早期年龄显示出对无反应的预测趋势（p = .056）。在单变量分析中，混合强迫症（p = .001）和缺乏洞察力（p = .023）与无反应相关。结论：本研究确定了对SRI无反应的临床预测因素。当开具SRI治疗OCD时，可能需要考虑并仔细评估这些预测因素。未来的研究应着眼于确定对SRI无反应者有效的治疗方式。

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