A Pilot Study On Symptom Dimensions And Quality Of Life In Patients With Obsessive-compulsive Disorder

Objective : To explore the symptom dimensions in Chinese patients with obsessive-compulsive disorder(OCD), it was aimed to provide a way to dissect the phenotype into homogeneous subtypes and to examine whether symptom dimensions were stable across cultures. The impairments of quality of life in patients with OCD were investigated, and to examine whether impairments of quality of life were related to symptom dimensions.Methods: First, a factor analysis of Yale-Brown Obsessive-Compulsive Scale Symptoms Checklist on Chinese outpatients with OCD(N=78), to identify the symptom structure. Then, to compare the clinical characteristics between OCD patients with distinct symptom dimension, such as age, age at onset, duration of education, Y-BOCS score, and so on. Second, the WHOQOL-BREF was administered to the outpatients group with OCD and 60 normal controls, then their score were compared. Third, to compare the WHOQOL-BREF scores between OCD patients with distinct symptom dimension.Results: (1) Four significant factors explaining 74.7% of the variance were identified:â‘ contamination/washing;â‘¡checking/aggressive symptoms;â‘¢hoarding;â‘£symmetry/ repeating and ordering. According to the presenting symptom dimension, OCD patients were divided to four groups, as follow Washing group, Checking group, Hoarding group and Symmetry group. Among the four groups, there were significant difference in duration of education, age at onset, Y-BOCS total score and insight score (each F value were 4.35, 4.06, 3.71 and 3.16, all P<0.05). (2) Compared to normal controls, OCD patients showed significant impairments in all domains of quality of life (P<0.0001). Severity of obsessions, compulsions and depressive symptoms were significant predictors of impairment of quality of life in OCD patients.(3) Between Washing, Checking, Hoarding and Symmetry group, there showed significantly different severity of the impairments in the Physical well-being, Psychological well-being, Environment and Social relationship subscore of WHOQOL- BREF (each F value were 5.85, 6.38, 5.89 and 3.76, all P<0.05).Conclusions: (1)The findings in this study support transcultural stability in the symptom structure of OCD. These symptom dimensions are related to different clinical characteristics. (2)All aspects of quality of life are markedly affected in individuals with OCD and are associated with OCD severity and depression severity. (3) The symptom dimensions are related to different impairments of quality of life in patients with OCD. Hoarding symptoms are related to significant impairments in Psychological well-being Environment and Social relationship domains, and Washing symptoms are related to Physical well-being domain.