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目的:探讨和区分出强迫症的临床亚型,及各亚型与药物治疗的关系.方法:采用临床研究与家系遗传研究相结合的方法,对90例未服药的强迫症的临床特征、合并疾病、一级亲属的精神疾病发病情况及治疗反应进行研究.结果:单纯强迫观念组、强迫观念伴强迫行为组及伴有抽动障碍的强迫症组在临床特征、合并疾病、家系遗传及治疗反应等方面显示显著的差异.单纯强迫观念组具有较高的焦虑分,合并疾病及家系一级亲属中焦虑障碍明显高于其它两组,对氯丙咪秦的疗效达87.1％,自知力完整,预后好.伴有抽动障碍的强迫症发病年龄早(16.4岁),男性明显高于女性(10∶1),合并疾病及一级亲属中的精神分裂症、抽动障碍及重性抑郁患病率明显增高,对氯丙咪秦的疗效差(35.7％),社会功能受损重,预后差.强迫行为组临床特征介于二者之间.结论:这三组强迫症可能是不同的临床亚型且显示本病从神经症特征到精神病特征之间的连续谱“,”Objective:To explore the clinical subtypes of obsessive-compulsive disorder(OCD) andtheir relationship to medical treatment. Methods: Clinical assessment and family genetic method were used to study the clinical characteristics, comorbidity, family spectrum, and response to treatment of 90 unmediated patients with OCD. Results: The group of patients with obsessions showed more anxiety symptoms, an increased comorbidity with anxiety disorders, an increased prevalence of anxiety disorders in the fir...