T.H. Ha, et al 강박증상과공존인격병리 연구대상 - - 평가도구 Table 1. Clinical variables of 130 patients male89, female41 with OCD Variables Minimum Maximum Mean SD Age O

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1 KISEP Original Article J Korean Neuropsychiatr Assoc Vol 43, No 1 강박장애의증상차원과공존인격병리의관련성에관한연구 서울대학교의과대학정신과학교실, 1 축령복음병원, 2 성신여자대학교심리학과 3 하태현 1 윤탁 2 노규식 1 김명선 3 권준수 1 Symptom Dimensions of Obsessive-Compulsive Disorder and Their Relation to Comorbid Personality Pathology Tae Hyon Ha, MD 1, Tak Youn, MD 2, Kyu Sik Rho, MD 1, Myung-Sun Kim, PhD 3 and Jun Soo Kwon, MD, PhD 1 Department of Psychiatry, 1 Seoul National University College of Medicine, Seoul, Chook Ryoung Evangelical Hospital, 2 Namyangju, Department of Psychology, 3 Sungshin Women s University, Seoul, Korea Objectives:A great deal of attention has been paid to comorbid personality disorders in obsessive-compulsive disorder not only from the theoretical perspectives but also from the clinical aspects related to the prediction of the treatment response. The purpose of the current study was to investigate the relations of the symptoms dimensions in OCD to the comorbid personality pathology. Methods:One-hundred thirty subjects with OCD completed Yale-Brown Obsessive Compulsive Scale (YBOCS) and Personality Disorder Questionnaire-4+ (PDQ-4+). Factor scores of symptom dimensions yielded from a factor analysis of 13 categories in YBOCS symptom checklist were inspected how to be related with the presence of any personality disorder and the PDQ scores for cluster A, B, and C personality pathology. Results:The PDQ total score was significantly correlated with aggressive/sexual/religious obsessions, hoarding, and symmetry/ordering dimensions. The hoarding and repeating/counting dimensions were correlated with cluter A pathology, the symmetry/ordering dimension was with cluster B pathology, while the obsessions dimension was globally related to personality disorders of all the clusters. Conclusion:These findings add the evidence of the heterogeneity of OCD. The presence of pure obsessions, hoarding, and symmetry/ordering dimensions may need a close screening for comorbid personality disorders and individualized therapeutic strategies. (J Korean Neuropsychiatr Assoc 2004;43(1):46-53) KEY WORDS:Obsessive-compulsive disorder Personality disorders Symptom dimensions. 46 서 - 론 -

2 T.H. Ha, et al 강박증상과공존인격병리 연구대상 - - 평가도구 Table 1. Clinical variables of 130 patients male89, female41 with OCD Variables Minimum Maximum Mean SD Age Onset age Illness duration YBOCS score Obsessions Compulsions Total score YBOCSyale-brown obsessive compulsive scale 방 법 47

3 강박증상과공존인격병리 T.H. Ha, et al - - 통계분석 결과 강박증상의빈도및요인분석결과 - Table 2. Frequencies of the major symptom categories of the yale-brown obsessive compulsive scale symptom checklist Men n89 Women n41 All patients n130 Symptom category Major symptom Present symptom* Major symptom Present symptom* Major symptom Present symptom* N N N N N % N % Obsessions Aggressive Contamination Sexual Hoarding Religious Symmetry Somatic Compulsions Cleaning Checking Repeating Counting Ordering Hoarding Including major symptom 48

4 T.H. Ha, et al 강박증상과공존인격병리 Factor 1 Factor 2 Factor 3 Factor 4 Factor 5 Aggressive 0.71 Obsessions loadings Contamination 0.93 Symmetry 0.81 Sexual 0.78 Hoarding 0.86 Compulsions loadings Cleaning 0.89 Ordering 0.84 Religious 0.52 Hoarding 0.86 Counting 0.83 Repeating 0.79 Fig. 1. Five factors identified by principal component analysis with varimax rotation of 13 major symptom categories from 130 patients with OCD. Table 3. Distribution of comorbid personality disorders in 130 patients with OCD No. of patients Percent % Any Cluster A Paranoid Schizoid Schizotypal Cluster B Histrionic Narcissistic Borderline Antisocial Cluster C Avoidant Dependent Obsessive-compulsive Other Negativistic Depressive None 공존인격장애의빈도및인구학적특성 - 공존인격병리와강박증상간의상관성 49

5 강박증상과공존인격병리 T.H. Ha, et al - - Personality disorders F1 Symptom dimensions and symptom severity F2 F3 F4 F5 YBOCS Paranoid A Schizoid Schizotypal Histrionic B Narcissistic Borderline Antisocial Avoidant C Dependent Obsessivecompulsive Negativistic Depressive Significant difference in the factor scores or YBOCS scores between groups with and without a specific personality disorder in a Mann- Whitney U test p0.05 Significant correlation between the factor scores or YBOCS scores and the presence of a specific personality disorder or PDQ scores in a logistic or multiple regression analysis p0.05 Fig. 2. The relation of symptom dimensions and symptom severity to the comorbid personality pathology in OCD. F 1-5Factor scores of symptom dimensions. YBOCS total score of Yale Brown Obsessive Compulsive Scale. 50

6 T.H. Ha, et al 강박증상과공존인격병리 고찰

7 강박증상과공존인격병리 T.H. Ha, et al - - 결론 52

8 T.H. Ha, et al 강박증상과공존인격병리 중심단어 REFERENCES 1) Zohar AH, Pauls DL, Ratzoni G, Apter A, Dycian A, Binder M, et al. Obsessive-compulsive disorder with and without tics in an epidemiological sample of adolescents. Am J Psychiatry 1997;154: ) Rasmussen SA, Tsuang MT. Clinical characteristics and family history in DSM-III obsessive-compulsive disorder. Am J Psychiatry 1986; 143: ) Foa EB, Grayson JB, Steketee GS, Doppelt HG, Turner RM, Latimer PR. Success and failure in the behavioral treatment of obsessivecompulsives. J Consult Clin Psychol 1983;51: ) Leckman JF, Zhang H, Alsobrook JP, Pauls DL. Symptom dimensions in obsessive-compulsive disorder: toward quantitative phenotypes. Am J Med Genet 2001;105: ) Rasmussen SA, Eisen JL. The epidemiology and clinical features of obsessive compulsive disorder. Psychiatr Clin North Am 1992;15: ) Baer L. Factor analysis of symptom subtypes of obsessive compulsive disorder and their relation to personality and tic disorders. 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서론 1. 연구대상 1) 정상군 연구대상및방법 2) 성격장애군 526

서론 1. 연구대상 1) 정상군 연구대상및방법 2) 성격장애군 526 KISEP Original Articles 39 3 2000 J Korean Neuropsychiatr Assoc Vol 39, No 3 국문초국문 연구목적 : 한국판성격장애검사 (Personality Disorder Questionnaire-4+:PDQ-4+) 의신뢰도와 타당도에관한예비적연구 김동인 * 최말례 * 조은정 ** The Preliminary Study