Iranian Journal of Psychiatry and Clinical Psychology
مجله روانپزشكي و روانشناسي باليني ايران
IJPCP
Medical Sciences
http://ijpcp.iums.ac.ir
18
journal18
1735-4315
2228-7515
10.32598/ijpcp
fa
jalali
1385
5
1
gregorian
2006
8
1
12
2
online
1
fulltext
fa
آیا همراهی اختلال وسواسی- اجباری با اختلال دوقطبی نوع یک کمتر از اختلال افسردگی اساسی است؟
Is the Comorbidity of Obsessive-compulsive Disorder with Bipolar I Disorder Less than Major Depressive Disorder?
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