fa آیا همراهی اختلال وسواسی- اجباری با اختلال دوقطبی نوع یک کمتر از اختلال افسردگی اساسی است؟ روانپزشکی و روانشناسی Psychiatry and Psychology پژوهشي اصيل Original Research <font size="4"><strong> چکیده</strong></font><p class="a" dir="rtl"><span lang="AR-SA" style="FONT-SIZE: 10pt FONT-STYLE: normal FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><strong>مقدمه:</strong></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><strong> </strong>بررسی‌ها گویای برتری میزان همبودی اختلال وسواسی </span><span dir="ltr"></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma"><span dir="ltr"></span>–</span><span dir="rtl"></span><span style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <span lang="AR-SA"><font size="2">اجباری </font></span></span><span dir="ltr"></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma"><span dir="ltr"></span>(OCD)</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> در بیماران دوقطبی نسبت به بیماران مبتلا به اختلال افسردگی اساسی </span><span dir="ltr"></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma"><span dir="ltr"></span>(MDD)</span><span dir="rtl"></span><span style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <span lang="AR-SA"><font size="2">هستند. ولی در زمینه مقایسه این همبودی بین اختلال دوقطبی نوع یک </font></span></span><span dir="ltr"></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma"><span dir="ltr"></span>(BID)</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> و </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">MDD</span><span dir="rtl"></span><span style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <font size="2"><span style="mso-spacerun: yes"> </span><span lang="AR-SA">یافته‌های موجود اندک است. این پژوهش با هدف چنین مقایسه‌ای انجام شده است. <p></p></span></font></span></p><p class="a" dir="rtl"><span lang="AR-SA" style="FONT-SIZE: 10pt FONT-STYLE: normal FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><strong>روش:</strong></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><strong> </strong>در یک مطالعه مقطعی، 466 بیمار مراجعه‌کننده به چهار مرکز روانپزشکی دانشگاهی شهر تهران به‌کمک فهرست معیارهای تشخیصی </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">DSM-IV</span><span dir="rtl"></span><span style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <span lang="AR-SA"><font size="2"><span style="mso-spacerun: yes"> </span>ارزیابی شدند و میزان همبودی همه عمر </font></span></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">OCD</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> در بیماران مبتلا به </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">MDD</span><span dir="rtl"></span><span style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <font size="2"><span style="mso-spacerun: yes"> </span><span lang="AR-SA">و </span></font></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">BID</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> محاسبه و با روش‌های آماری توصیفی و تحلیلی بررسی شد.<p></p></span></p><p class="a" dir="rtl"><span lang="AR-SA" style="FONT-SIZE: 10pt FONT-STYLE: normal FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><strong>یافته‌ها:</strong></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><strong> </strong>124 مورد </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">MDD</span><span dir="rtl"></span><span style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <font size="2"><span style="mso-spacerun: yes"> </span><span lang="AR-SA">و 115 مورد </span></font></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">BID</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> تشخیص داده شد که از نظر میانگین سنی و سایر ویژگی‌های جمعیت‌شناختی تفاوت معنی‌دار آماری نداشتند. میزان موارد بستری و نوع راجعه اختلال در گروه </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">BID</span><span dir="rtl"></span><span style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <font size="2"><span style="mso-spacerun: yes"> </span><span lang="AR-SA">به‌طور معنی‌دار بیش از گروه دیگر بود. میزان همبودی همه عمر </span></font></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">OCD</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> در گروه </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">MDD</span><span dir="rtl"></span><span style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <font size="2"><span style="mso-spacerun: yes"> </span><span lang="AR-SA">7/17%‌ و در گروه </span></font></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">BID</span><span dir="rtl"></span><span style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <font size="2"><span style="mso-spacerun: yes"> </span><span lang="AR-SA">7%‌ بود که تفاوت معنی‌دار داشت (05/0</span></font></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">p<</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> ). هیچ موردی از همبودی </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">OCD</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> در بیماران مبتلا به نخستین دوره‌ مانیا وجود نداشت و از این نظر تفاوت معنی‌داری بین بیماران مبتلا به </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">MDD</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> یک دوره‌ای و </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">MDD</span><span dir="rtl"></span><span style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <font size="2"><span style="mso-spacerun: yes"> </span><span lang="AR-SA">راجعه دیده نشد.<p></p></span></font></span></p><p class="a" dir="rtl"><span lang="AR-SA" style="FONT-SIZE: 10pt FONT-STYLE: normal FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><strong>نتیجه‌گیری:</strong></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><strong> </strong>همبودی همه عمر </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">OCD</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> در بیماران مبتلا به </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">MDD</span><span dir="rtl"></span><span style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <font size="2"><span style="mso-spacerun: yes"> </span><span lang="AR-SA">چشمگیر است و ممکن است بیش از بیماران </span></font></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">BID</span><span dir="rtl"></span><span style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <font size="2"><span style="mso-spacerun: yes"> </span><span lang="AR-SA">باشد.<p></p></span></font></span></p><p class="a" dir="rtl"><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><p> </p></span></p>  <p class="MsoNormal" style="TEXT-JUSTIFY: kashida DIRECTION: ltr TEXT-INDENT: 0cm LINE-HEIGHT: 15pt MARGIN-RIGHT: 6.5pt unicode-bidi: embed TEXT-ALIGN: justify TEXT-KASHIDA: 0% mso-line-height-rule: exactly"><b><span style="FONT-SIZE: 10pt FONT-FAMILY: "Arial Black" mso-bidi-font-family: 'B Lotus'">Abstract<p></p></span></b></p><p class="MsoNormal" style="TEXT-JUSTIFY: kashida DIRECTION: ltr TEXT-INDENT: 0cm LINE-HEIGHT: 15pt MARGIN-RIGHT: 6.5pt unicode-bidi: embed TEXT-ALIGN: justify TEXT-KASHIDA: 0% mso-line-height-rule: exactly"><b><span style="FONT-SIZE: 10pt mso-bidi-font-family: 'B Lotus'">Objectives: </span></b><span style="FONT-SIZE: 10pt mso-bidi-font-family: 'B Lotus'">Based on current evidence, comorbidity of obsessive-compulsive disorder (OCD) in bipolar patients is higher than in patients with major depressive disorder (MDD). However, there is little data regarding the comparison of this comorbidity between bipolar I disorder (BID) and MDD. The aim of the present project was to carry out this comparison.<p></p></span></p><p class="MsoNormal" style="TEXT-JUSTIFY: kashida DIRECTION: ltr TEXT-INDENT: 0cm LINE-HEIGHT: 15pt MARGIN-RIGHT: 6.5pt unicode-bidi: embed TEXT-ALIGN: justify TEXT-KASHIDA: 0% mso-line-height-rule: exactly"><b><span style="FONT-SIZE: 10pt mso-bidi-font-family: 'B Lotus'">Method:</span></b><span style="FONT-SIZE: 10pt mso-bidi-font-family: 'B Lotus'"> 466 patients referred to four psychiatric university centers in </span><city><place><span style="FONT-SIZE: 10pt mso-bidi-font-family: 'B Lotus'">Tehran</span></place></city><span style="FONT-SIZE: 10pt mso-bidi-font-family: 'B Lotus'"> were evaluated by DSM-IV diagnostic criteria checklist. The rates of lifetime comorbidity of OCD in MDD and BID patients were calculated, and data were analyzed by descriptive and analytic statistical methods. <p></p></span></p><p class="MsoNormal" style="TEXT-JUSTIFY: kashida DIRECTION: ltr TEXT-INDENT: 0cm LINE-HEIGHT: 15pt MARGIN-RIGHT: 6.5pt unicode-bidi: embed TEXT-ALIGN: justify TEXT-KASHIDA: 0% mso-line-height-rule: exactly"><b><span style="FONT-SIZE: 10pt mso-bidi-font-family: 'B Lotus'">Results: </span></b><span style="FONT-SIZE: 10pt mso-bidi-font-family: 'B Lotus'">124 cases of MDD and 115 cases of BID were diagnosed. The demographic variables of two groups did not have significant difference. The rate of admissions and recurrent type of disorder in the BID group were significantly higher than those of the other group. The lifetime comorbidity of OCD in MDD and BID patients was 17.7% and 7%, respectively, and the difference was statistically significant (p<0.05). There was no case of comorbidity of OCD in patients with first episode of mania. The rates of comorbidity of OCD in patients with single episode MDD and with recurrent MDD did not have significant difference.<p></p></span></p><p class="MsoNormal" style="TEXT-JUSTIFY: kashida DIRECTION: ltr TEXT-INDENT: 0cm LINE-HEIGHT: 15pt MARGIN-RIGHT: 6.5pt unicode-bidi: embed TEXT-ALIGN: justify TEXT-KASHIDA: 0% mso-line-height-rule: exactly"><b><span style="FONT-SIZE: 10pt mso-bidi-font-family: 'B Lotus'">Conclusion: </span></b><span style="FONT-SIZE: 10pt mso-bidi-font-family: 'B Lotus'">The lifetime comorbidity of OCD in patients with MDD is significant and may be higher than in BID patients.<p></p></span></p><p class="MsoNormal" style="TEXT-JUSTIFY: kashida DIRECTION: ltr TEXT-INDENT: 0cm LINE-HEIGHT: 15pt MARGIN-RIGHT: 6.5pt unicode-bidi: embed TEXT-ALIGN: justify TEXT-KASHIDA: 0% mso-line-height-rule: exactly"><b><i><span style="FONT-SIZE: 9pt mso-bidi-font-family: 'B Lotus'"><p> </p></span></i></b></p> کلیدواژه: اختلال وسواسی – اجباری، اختلال دوقطبی، مانیا، ‌اختلال افسردگی اساسی، همبودی Key words: obsessive-compulsive disorder (OCD), bipolar disorder, mania, major depressive disorder (MDD), comorbidity 117 123 http://ijpcp.iums.ac.ir/browse.php?a_code=A-10-1-19&slc_lang=fa&sid=1 Amir Shabani امیر شعبانی E-mail: amirshabani@tehranpi.org 18003194753284600914 18003194753284600914 Yes Vandad Sharifi ونداد شریفی 18003194753284600915 18003194753284600915 No Javad Alaghband-rad جواد علاقبندراد 18003194753284600916 18003194753284600916 No Zahra Shahrivar زهرا شهریور 18003194753284600917 18003194753284600917 No Homayun Amini همایون امینی 18003194753284600918 18003194753284600918 No Hossein Kaviani حسین کاویانی 18003194753284600919 18003194753284600919 No Mitra Hakim Shooshtari میترا حکیم شوشتری 18003194753284600920 18003194753284600920 No Elham Shirazi الهام شیرازی 18003194753284600921 18003194753284600921 No Rozita Davari-ashtiani رزیتا داوری آشتیانی 18003194753284600922 18003194753284600922 No Fariba Arabgol فریبا عربگل 18003194753284600923 18003194753284600923 No