기질-정서 특성에서 본 강박증의 취약인자 및 단기 약물치료의 영향

Vulnerability Factors of Obsessive-Compulsive Disorder on the Temperamental and Affective Aspects and the Effect of Pharmacotherapy

이번 연구에서는 56명의 강박증 환자와 70명의 정상 대조군을 대상으로 기질-정서-행동 특성에 대한 자기 보고식 검 사를 시행, 결과를 비교하였다. 강박증 환자들이 사고 촉진과 정서 조절 영역의 정서 지능이 저하되어 있고, 행동 억제화 민감도는 높으며 충동성 및 분노 경험이 많은 것으로 측정되었으며, 4개월의 약물 치료 후 증상의 호전이 있었음에도 이들 특성은 별 다른 변화가 없었음을 확인하였다. 이는 상기 인자들이 특성 의존적이며, 강박증의 취약인자가 될 가능 성이 있음을 시사한다고 본다.

ObjectivezzRecently some behavioral features and affective traits are considered important for the phenotype of obsessivecompulsive disorder (OCD). The purpose of this study was to assess some specific behavioral, temperamental, emotional features of OCD patients and to investigate if there is any change in patterns of temperament-character after 4-month pharmacotherapy. MethodszzFifty-six patients with OCD and 70 normal controls were enrolled in this study. Four self-report questionnaires were employed to assess temperamental characteristics and affective traits: The behavioral inhibition system and behavioral activation system scale, the Baratt impulsiveness scale, state-trait anger expression inventory, emotional intelligence inventory. Among 56 OCD patients, 21 subjects started pharmacotherapy and 4 months later, they repeated 4 self-report tests as the same above and Yale-Brown obsessive compulsive scale (Y-BOCS). And then we investigated the changes from initial results. ResultszzPatients with OCD showed significantly greater expression of behavioral inhibition system (p˂0.0001), more cognitive impulsiveness (p˂0.0001), motor impulsiveness (p=0.0067) and increased level of state anger (p˂0.0001), trait anger (p˂0.0001) than healthy controls. Compared to the controls, the OCD patients also expressed significantly lower level of emotional intelligence for using to facilitate thinking (p˂0.0001) and managing emotions (p˂0.0001). After 4-month pharmacotherapy for 21 OCD patients, Y-BOCS scores significantly decreased while self-report tests showed no meaningful differences from baseline assessments. ConclusionzzOur results suggest that patients with OCD may have some differences in behavioral and affective tendencies including behavioral inhibition, impulsiveness, anger experiences, and emotional patterns. And short term pharmacotherapy during 4 months improved the severity of obsessive-compulsive symptoms but didn’t influence these traits. These results provide some perspectives about possible vulnerability or trait markers of OCD. Further research is needed to examine the effects of long term treatment and other investigation might be helpful to assess the relationships between these behavioral and affective aspects and clinical phenotypes of OCD.