Yale-Brown Obsessive-Compulsive Scale과 Yale-Brown Obsessive-Compulsive Scale Checklist의 차원적 분석 = Dimensional Analyses of the Yale-Brown Obsessive-Compulsive Scale and Yale-Brown Obsessive-Compulsive Scale Checklist

국문 초록 (Abstract)

연구목적：비록 강박장애가 오랜 시간동안 하나의 단일한 진단으로 취급되어 왔지만 최근에는 강박장애가 동질의 질환이 아닐 가능성이 제기되고 있다. 또한 Yale-Brown Obsessive-Compulsive Scale(Y-BOCS)는 강박장애 증상을 평가하는 도구로 가장 널리 사용되어 왔지만 실제로 강박장애의 병태생리를 반영하는 여러 변수들과 Y-BOCS 하위척도와는 의미 있는 상관성을 보이지 않은 경우가 많다. 따라서 본 연구에서는 Y-BOCS checklist로부터 강박증상의 차원적 구조를 명확히 밝히고 아울러 Y-BOCS의 요인 구조를 알아보고자 한다. 연구방법：95명의 강박장애 환자들이 연구에 참여하였다. 환자들에게 Y-BOCS와 Y-BOCS checklist를 시행하였고 Y-BOCS checklist의 13개 범주, 그리고 Y-BOCS의 10개 항목을 각각 요인분석 하였다. 결 과：주요인분석을 통해 Y-BOCS checklist로부터 4개의 요인을 추출하였다. 4개의 요인은 저장/반복, 오염/청결, 공격적/성적, 그리고 종교적/신체적 강박요인으로 총 변이의 62.7%를 설명해 주었다. Y-BOCS로부터 3개의 요인을 추출하였다. 3개의 요인은 강박사고의 심각도, 강박행동의 심각도, 그리고 강박증상에 대한 저항 요인이었고 총 변이의 75.29%를 설명해 주었다.
결 론：Y-BOCS checklist로부터 4개의 요인이 그리고 Y-BOCS로부터 3개의 요인이 추출되었으며 이들 요인은 향후 유전적, 신경생물학적 그리고 치료 반응에 대한 연구에 많은 도움이 될 것이다.

다국어 초록 (Multilingual Abstract)

Objectives
Although obsessive-compulsive disorder(OCD) has long been a unitary diagnosis, there is much recent interest in its potential heterogeneity, as manifested by symptom subgroups. And although the Yale-Brown Obsessive-Compulsive Scale(Y-BOCS) is a widely used instrument to assess obsessive-compulsive symptomatology, the variables reflecting the pathogenesis of OCD and Y-BOCS subscores usually were not significantly associated. The aims of this study are to clarify identification of dimensional structure of the symptoms from Y-BOCS checklist and to explore the factor structure of the Y-BOCS.
Methods
Ninety five OCD patients participated in this study and performed the Y-BOCS and Y-BOCS checklist. The 13 main symptom categories from Y-BOCS checklist and 10 items from Y-BOCS were factor analyzed by using principal components analysis, respectively.
Results
Using principal component analysis, we derived 4 factors from 13 main contents of Y-BOCS checklist. Four factors – hoarding/repeating, contamination/cleaning, aggressive/sexual, and religious/somatic – accounted for more than 60% of the variance. And we derived 3 factors from 10 items of Y-BOCS and these 3 factors – severity of obsession, severity of compulsion, and resistance to symptoms – accounted for more than 70% of variance.
Conclusions
The four symptom dimensions from Y-BOCS checklist and three symptom dimensions from Y-BOCS were identified as significant factors accounting for the variance. These factors may be of value in future genetic, neurobiological, and treatment response studies.

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