ABSTRACT

This systematic review and meta-analysis aimed to investigate the relationship between dissociation and obsessive-compulsive symptoms (OCS) and disorder (OCD). Specifically, the study aimed to (a) estimate the pooled prevalence of dissociative disorders among individuals with OCD; (b) systematically review the prevalence of OCD among individuals with dissociative disorders; (c) compare the severity of dissociative symptoms between individuals with OCD and non-clinical controls; (d) estimate the association between OCS and dissociative symptoms in the clinical and non-clinical populations. A systematic search was carried out in biomedical databases from inception to January 2022 according to PRISMA guidelines. A total of 41 studies met inclusion criteria (n = 9,438, 34.3% males). The pooled prevalence of dissociative disorders in adult samples with OCD was 8% (95% CI [3, 15], k = 5). Studies on adolescent and adult patients with dissociative disorders found that 17–32% reported comorbid OCD, while a prospective study of patients with early-onset dissociative disorders found no evidence of association with OCD. Individuals affected by OCD reported more dissociative symptoms than non-clinical controls (g = .67, 95% CI [.18, 1.16], k = 9). A moderate correlation between dissociative symptoms and OCS was detected (r = .43, 95% CI [.36, .51], k = 18). Sensitivity analyses showed small/moderate correlations between dissociative experiences and specific types of obsessions and compulsions. Findings suggest that dissociative symptoms are moderately related to OCS in both clinical and non-clinical populations. Interventions aimed to reduce dissociation might improve treatment response of patients suffering from OCD.

摘要

本系统回顾和荟萃分析旨在调查解离与强迫症状 (OCS) 和障碍 (OCD) 之间的关系。具体而言，该研究旨在 (a) 估计强迫症患者中解离障碍的合并患病率；(b) 系统审查强迫症在分离性障碍患者中的​​患病率；(c) 比较强迫症患者和非临床对照者分离症状的严重程度；(d) 估计临床和非临床人群中 OCS 与解离症状之间的关联。根据 PRISMA 指南，从开始到 2022 年 1 月，在生物医学数据库中进行了系统搜索。共有 41 项研究符合纳入标准（n = 9,438，34.3% 为男性）。强迫症成人样本中解离障碍的合并患病率为 8%（95% CI [3, 15]，k  = 5）。对患有分离性障碍的青少年和成年患者的研究发现，17-32% 的人报告患有强迫症，而一项针对早发性分离性障碍患者的前瞻性研究没有发现与强迫症相关的证据。受 OCD 影响的个体比非临床对照者报告更多的分离症状 ( g  = .67, 95% CI [.18, 1.16], k  = 9)。检测到解离症状与 OCS 之间存在中度相关性 ( r  = .43, 95% CI [.36, .51], k = 18). 敏感性分析显示解离体验与特定类型的强迫症和强迫症之间存在小/中等相关性。研究结果表明，在临床和非临床人群中，分离症状与 OCS 有中等程度的相关性。旨在减少分离的干预措施可能会改善强迫症患者的治疗反应。