Frühe interpersonale traumatisierungen bei zwangserkrankungen

Background: Early traumatic experiences are discussed as risk factors for the development of psychiatric disorders and are suspected to influence treatment and outcome. Yet, few empirical studies have assessed the association between these life events and obsessive-compulsive disorder (OCD). Especially the role of emotional abuse and physical and emotional neglect has rarely been examined. Therefore, the aim of the present study was to investigate the prevalence of early traumatic experiences in patients with OCD and the impact of such experiences on OCD severity and symptom features as well as on treatment outcome. Patients and Methods: 41 patients fulfilling criteria of OCD were investigated with several instruments (Structured Trauma Interview, STI; Childhood Trauma Questionnaire, CTQ; Yale Brown Obsessive-Compulsive Scale, Y-BOCS etc.) before and after treatment. Patients were consecutively referred to a behaviour therapy inpatient unit. Treatment consisted of an individualized and multimodal cognitive behaviour therapy (with or without drug therapy). Results: The findings indicate a high prevalence of childhood traumatic experiences in OCD patients. Traumatic experiences were associated with a higher level of psychiatric symptoms in general, depressive symptoms and severity of OCD (on a trend level). The results are not supportive of a relationship between traumatic experiences and treatment failure. Conclusion: Adverse childhood experiences such as abuse and neglect are relatively prevalent among patients with OCD. These experiences are associated with greater psychopathology, but not necessarily with an unfavourable outcome. Recommendations for the treatment of these patients are discussed.