強迫症對修正版威斯康辛卡片分類測驗表現之影響

ૻ࢝া၆࣒ϒۍރ೻૵֙Ι̶ͯᙷീរܑன̝ᇆᜩ

ዑ൶̥2_ă܅ࡷ⎾3 1઼ϲјΑ̂ጯҖࠎᗁጯࡁտٙ 2_{઼ϲέ៉̂ጯ͕நጯր} ၡࢋ ϫ۞ĈА݈ࡁտ൴னૻ࢝াଈ۰д൑ᖼೱ೩ϯ۞ރ೻૵֙Ι̶ͯᙷീរܑன˯ځព΍ன׽ેّ᏾ᄱĄώࡁտ͹ࢋͽ࣒ϒۍރ೻૵֙Ιͯ ̶ᙷീរࠎ̍׍Ăᑭീ೩ϯᖼೱቢ৶ߏӎΞԼតૻ࢝াଈ۰̝׽ેّ᏾ᄱĂϫ۞дซ˘Վᗃ୻ૻ࢝াଈ۰̝͹ࢋᄮۢᅪᘣĂ֭ഇ ೩ֻᓜԖ̍ү۰Ꮚᝥᄃڼᒚྻϡ̝ણ҂Ą ͞ڱĈ22Ҝૻ࢝াଈ۰ͽ̈́22Ҝ൑ჟৠ়ঽٕৠགྷ়ঽΫ̝ϒ૱၆໰௡࣎९Ă׌௡ͽѐ᛬ăّҾăିֈ඀ޘតีΐͽ੨၆ĄՏҜણᄃ࣎ ९࠰Ԇјރ೻૵֙Ι̶ͯᙷീរăᄬ͛ം˧ീរăͽ̈́াېᚑࢦޘᄃଐჰณܑෞҤĄ ඕڍĈૻ࢝া௡ᄃ၆໰௡តளᇴ̶ژඕڍĂдރ೻૵֙Ι̶ͯᙷീរ۞׽ેّ᏾ᄱ޽ᇾ྿ព඾मளĄ়ঽᚑࢦޘᄃރ೻૵֙Ι̶ͯᙷീ រЧี޽ᇾ࠹ᙯ֭൑ព඾࠹ᙯĄ̙Тૻ࢝াې჌ᙷĞᑭߤ۰ᄃܧᑭߤ۰ğᄃˠ˾ጯតีăଐჰณܑăাېᚑࢦޘณܑͽ̈́ৠགྷ͕ நീរ޽ᇾซҖ൑ϓᇴតளᇴ̶ژᑭؠĂඕڍពϯ่дރ೻૵֙Ι̶ͯᙷീរ۞፾প᏾ᄱ޽ᇾ྿ព඾मளĄ ඕኢĈӈֹ࣒ϒۍރ೻૵֙Ι̶ͯᙷീរͽ೩ֻᖼೱቢ৶͞ёፆүĂૻ࢝াଈ۰̪൒Ӕனྵ੼۞׽ેّ᏾ᄱĂࡁտඕڍ͚޺׎͕Шనؠ ᖼೱ̝ᅪᘣͽ̈́ᗝཧΑਕ̙։̝ৠགྷঽநপᇈĄѣᝥٺૻ࢝াଈ۰͕நྻү৿ͻᇅّ̝ᄮۢপᇈĂдڼᒚ˯ޙᛉ̙آଳϡ೩ϯү ࠎڼᒚඉரĄТॡĂซ˘ՎޙᛉᓜԖ˯੫၆ૻ࢝া̝ᄮۢΑਕᅪᘣซҖৠགྷ͕நᏊᝥॡĂ࣒ϒۍރ೻૵֙Ι̶ͯᙷീរࠎᓜԖᏊ ᝥ˯ܮӀֹϡͷѣड़̝̍׍Ą ᙯᔣෟĈૻ࢝াă࣒ϒۍރ೻૵֙Ι̶ͯᙷീរăᗝཧăৠགྷ͕நᏊᝥ ఼ੈү۰Ĉ܅ࡷ⎾Ă106έΔξᘲ೻჊ྮα߱˘ཱི ઼ϲέ៉̂ጯ͕நጯր TelĈ02-23627076 E-mailĈhuams@ntu.edu.tw

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ૻ࢝াĞObsessive Compulsive DisorderğᓜԖ ়ঽপᇈࠎͅᖬ΍னૻ࢝ຍهĞobsessionğٕૻ࢝ ҖࠎĞcompulsionğĂଈ۰ᄮࠎ఺ֱૻ࢝ຍه̈́ૻ࢝ Җࠎߏ̙Ъநٕ࿅ޘ۞ĂࠤҌဘྏԩ١ૻ࢝ຍهซ ˢཝ̚Ăٕߏԩ١ેҖૻ࢝ҖࠎĂҭॡ૱Ϗਕԩ١ јΑĂЯѩౄјଐჰ˯۞൭ࡴٕߙ჌ۤົٕ࣎ˠΑ ਕ۞ᅪᘣĄܕೀѐૻ࢝া۞ৠགྷ࠹ᙯࡁտ႙צࢦ ෛĂଂཝᇆညͽ̈́ৠགྷ͕நጯࡁտពϯீுᗝཧϩ ኳăљ૲ϩኳă৳ېវͽ̈́ෛ͸ඈཝొડા̝ள૱ ૱֍ٺૻ࢝াଈ۰Ăጯ۰ซ˘Վᄮࠎᗝཧę৳ېវ ęෛ͸ęᗝཧᒖĞfrontal-striatum-thalamus-frontal-l o o pğ ள ૱ Ξ ਕ ࠎ ૻ ࢝ া ଈ ۰ ̝ ৠ གྷ ঽ ந প ᇈ

ĞChacko, Corbin, & Harper, 2000; Saxena, Brody,

Schwartz, & Baxter, 1998; Saxena & Rauch, 2000; Stein, 2000; Lacerda, Dalgalarrondo, Caetano, Hass, Camargo, & Keshavan , 2003ğĄ

ރ೻૵֙Ι̶ͯᙷീរٙീณ۞͕ந።඀࠹༊ ኑᗔĂΒ߁ໄهԛјăયᗟྋՙăࢍထă௡ᖐăࢍ ထᇅّă͕Шჯ޺ă׽ેّ᏾ᄱăਕӎֹϡᒖဩа 㒝Լត͕Шనؠͽ̈́Ժט኏જҖࠎඈΑਕĞLezak,

1995; Walsh & Dayby, 1999ğĄૄٺొ̶ૻ࢝াଈ۰ ۞ৠགྷঽநᄃᗝཧΑਕள૱ѣᙯĞSaxena et al., 1998; Saxena & Rauch, 2000; Stein, 2000ğĂЯѩރ೻ ૵֙Ι̶ͯᙷീរܜ˳ͽֽజጯ۰ֹϡٺീณૻ࢝ াଈ۰۞ેҖΑਕĂ൒҃ૻ࢝াଈ۰дྍീរ۞ࡁ տඕڍ̪൒̙˘࡭Ąѣֱጯ۰ᄮࠎૻ࢝াଈ۰дރ ೻૵֙Ι̶ͯᙷീរܑனͧϒ૱ˠमĞHead, Bolton, & Hymas, 1989; Lucey et al., 1997; Okasha, 2000; Moritz et al., 2001; Lacerda et al., 2003ğĂOkashaඈˠ Ğ2000ğซ˘Վ޽΍ૻ࢝াଈ۰дྍീរܑனྵमᄃ ˭ЕΑਕ̙։ѣᙯĂΒ߁ᖼೱ͕Шనؠਕ˧ă͕ந ଠטਕ˧ăᄮۢᇅّͽ̈́٩෪ޥ҂ਕ˧ඈĂ֭ͷᄮ ࠎѩᄃ࣎វᗝཧΑਕள૱ѣᙯĄҭ࠹၆۞Ă׎΁ࡁ տ۰ĞGambini, Abbruzzese, & Scarone, 1993; Gross-Isseroff et al., 1996; Abbruzzese, Ferri, & Scarone, 1995, 1997; Mataix-Cols, Junque, Sanchez-Turet, Vallrjo, Verger, & Barriors, 1999ğ֭Ϗ൴னૻ࢝াଈ ۰дѩീរܑனளٺ૱ˠĄ

ጯ۰ĞOtto, 1992; Gross-Isseroff et al., 1996; Greisberg & Mckey, 2003ğᕩৼૻ࢝াଈ۰ރ೻૵֙ Ι̶ͯᙷീរࡁտඕڍ̙˘࡭۞ࣧЯΞਕᄃᏴᇹᇾ ໤ă̒ᕘតี۞ଠטͽ̈́ീរۍώѣᙯĄдᏴᇹᇾ ໤͞ࢬĂMataix-ColsඈˠĞ1999ğͽયסᎡᏴ׍ૻ ࢝াې۞̂ጯϠซҖࡁտĂ఺ֱ࣎९֭Ϗͽᇾ໤෧ ᕝّົኘቁᄮૻ࢝া̝෧ᕝĄ׎΁ࡁտᔵ൒ͽ௑Ъ ᓜԖ෧ᕝᇾ໤۞ૻ࢝াଈ۰ࠎࡁտᇹώĂҭߏ၆ᇆ ᜩྍീរܑன۞̒ᕘតี֭Ϗග̟ዋ༊̝ଠטĄА ݈ࡁտពϯྍീរܑன۞̒ᕘតีΒ߁Ĉૻ࢝াې ᚑࢦޘăВঽᇎ៭඀ޘͽ̈́ିֈ඀ޘĂѣֱጯ۰ ĞHead et al., 1989; Abbruzzese et al., 1997ğࡁտ֭̚ Ϗଠטૻ࢝াېᚑࢦޘᄃВঽᇎ៭඀ޘ఺׌࣎̒ᕘ តีĂ҃LacerdaඈˠĞ2003ğ۞ࡁտᔵ൒ଠט˞় ঽᚑࢦޘតีĂҭ֭Ϗᑭീૻ࢝াࡁտ࣎९۞Вঽ ᇎ៭඀ޘĂGambiniĞ1993ğ۞ࡁտ̚݋ߏ၆ିֈ඀ ޘ̒ᕘតีϏග̟ዋ༊ଠטć˵ѣࡁտΪ߄Ᏼૻ࢝ াېᚑࢦޘྵ੼۞ૻ࢝াଈ۰үࠎࡁտ࣎९ĞGross-Isseroff et al., 1996ğĂ఺ֱ͞ڱጯ˯۞৿εᇆᜩ఺ֱ ࡁտඕڍଯኢ۞ѣड़ّĄጯ۰дࡁտ̚ଳϡ۞ރ೻ ૵ ֙ Ι ͯ ̶ ᙷ ീ រ ۍ ώ ˵ ѣ ̙ Т Ă к ᇴ ጯ ۰ ĞGambini et al., 1993; Gross-Isseroff et al., 1996; Abbruzzese et al., 1995, 1997; Lucey et al., 1997; Mataix-Cols et al., 1999; Okasha, 2000; Lacerda et al., 2003ğଳϡHeatonͩٺ1981ѐٙ൴ण۞ރ೻૵֙Ι ̶ͯᙷീរۍώĂҭߏૻ࢝াଈ۰дѩۍώ۞ܑன ֭Ϗ଀ז˘࡭۞ඕڍĄ͛ᚥ̚ΪѣHeadĞ1989ğଳ ϡ࣒ϒۍރ೻૵֙Ι̶ͯᙷീរĞNelson, 1976ğĂ дѩࡁտ̚Headֹϡ15Ҝ௑ЪᓜԖ෧ᕝᇾ໤۞ૻ࢝ াଈ۰ᄃ15Ҝϒ૱࣎९Ă҃఺׌௡צྏдѐ᛬ăّ Ҿͽ̈́ᄬ͛ംથඈតี˯ΐͽ੨၆Ăࡁտඕڍពϯ ૻ࢝াଈ۰ͧϒ૱၆໰௡ѣྵ੼۞׽ેّ᏾ᄱĂҭ ߏྍࡁտ֭Ϗଠטૻ࢝াېᚑࢦޘ̈́Вঽᇎ៭඀ޘ ඈ̒ᕘតีĂЯѩ׎ࡁտඕڍଯኢ۞ѣड़ّᅮࢋซ ˘ՎᑭរĄ ࠎ˞ԼචА݈ࡁտд͞ڱጯ˯۞৿εĂώࡁտ ͽࡠጆο६ૻ࢝াณܑĞYale-Brown Obsessive Compulsive ScaleğෞҤଈ۰াېᚑࢦޘĂТॡീณ ૻ࢝াଈ۰۞ᇎ៭ᄃ൏ᇋଐჰĂϡͽᑭീ়ঽᚑࢦ ޘăᇎᇋᄃ൏ᇋଐჰඈ̒ᕘតีᄃރ೻૵֙Ι̶ͯ ᙷ ീ រ ܑ ன ̝ ม ۞ ᙯ ᓑ Ą Т ॡ Ă ૄ ٺ ࿅ Ν ጯ ۰ ĞOkasha, 2000ğᔵ൒ᄮࠎૻ࢝াଈ۰дރ೻૵֙Ι ̶ͯᙷീរܑனָ̙ᄃ͕ШᖼೱӧᙱѣᙯĂͷϤٺ кᇴࡁտଳϡHeatonͩീរۍώĂྍീរۍώ֭Ϗ ೩ֻᖼೱ޽ጱᄬĂٙͽ൑ڱ଀ۢ೩ֻ఺჌γдቢ৶ ၆ૻ࢝াଈ۰ᖼೱҖࠎ۞ᇆᜩĄࠎ˞ซ˘Վᗃ୻ౄ јૻ࢝াଈ۰дރ೻૵֙Ι̶ͯᙷീរܑனָ̙۞ ᄮۢ፟טĂώࡁտᏴፄଳϡ೩ֻᖼೱ޽ጱᄬੈि۞ ࣒ϒۍރ೻૵֙Ι̶ͯᙷീរĞNelson, 1976ğĂϡ ͽᑭീ೩ֻγдቢ৶၆ଈ۰ീរܑன۞ᇆᜩĂᖣѩ ซ˘Վᗃ୻ଈ۰ߏӎΞᖣϤ೩ֻγࠧа㒝ٕγдቢ ৶ֽԼච͕ШనؠᖼೱᅪᘣĂซ҃ᑭෛᓜԖ၁ચᄃ ڼᒚඉர۞ᑕϡࢬ̝ΞҖّĄ

͞ڱ

Ğ˘ğࡁտ၆෪ ώࡁտࡁտ௡࣎९ֽ໚ࠎݑડߙᗁጯ͕̚,В22 ҜϤჟৠ૞ࡊᗁरֶDSM-IV෧ᕝ໤݋෧ᕝࠎૻ࢝া ଈ۰ણᄃѩࡁտĂଵੵѣჟৠঽাې۰Ăѐ᛬д20-41໐มĞπӮᇴ27.55ćᇾ໤म4.88ğĄϒ૱၆໰௡ͽ ѐ᛬ͽ̈́ିֈ඀ޘតีᄃࡁտ௡੨၆ĂВѣ22Ҝ൑ ჟৠ়ঽΫٕৠགྷጯ়ঽΫ۞ϒ૱ҋᙸ۰Ă̂кࠎ ᗁੰ̍үˠࣶͽ̈́̍үˠࣶछᛳĂ၆໰௡ѐ᛬д22-39໐มĞπӮᇴ27.41ćᇾ໤म4.04ğĄ׌௡ˠ˾ጯត ี̈́मளព඾ّ҂រඕڍӔனٺܑ˘Ă׌௡дѐ ᛬ăିֈѐᇴᄃّҾ˯࠰൑ព඾मளĄٙѣ࣎९࠰ ࠎҋᙸણᄃͷᘪԁТຍ३Ą Ğ˟ğࡁտ̍׍ ώࡁտീณᄬ͛ംથăૻ࢝াېᚑࢦޘăᇎ៭ ᄃ൏ᇋଐჰͽ̈́ރ೻૵֙Ι̶ͯᙷീរĂീរ̍׍ Βӣт˭: ᄬ͛ം˧ീរ

Intelligent Scale-Revisedğࠎ̍׍Ăֹϡᇴфᇃޘă ზఙăᙷТീរͽ̈́૱ᙊീរα̶࣎ീរଯҤ࣎९ ۞ᄬ͛ംથĄ

ૻ࢝াېᙷݭ̈́ᚑࢦޘീณֹϡ̍׍

ࡠጆο६ૻ࢝াณܑĞThe Yale-Brown Obsessive Compulsive Scale; Goodman, 1989a, 1989bğĈࠎ៍၅ ۰ෞҤณܑĂϫ۞ࠎീณϫ݈ૻ࢝াᚑࢦޘĞ౵ܕ ˘ฉğĂВ̶ࠎૻ࢝ຍهĞYOğᄃૻ࢝ҖࠎĞYCğ ׌࣎ณ͎,ෞҤШޘࠎাېᐛதᄃٙ܅෱ॡมă͟૱ Αਕצຫ඀ޘăଐჰӧᕘ඀ޘăܡԩᑀྏͽ̈́јΑ ܡԩඈ̣ีĂGoodmanĞ1989ğ̶ֶᇴ૟ᚑࢦޘ̶ ৺Ăᓁ̶10-20̶ࠎᅅޘĂ21-30̶ࠎ̚ޘĂ 31-40ࠎ ࢦޘĄҭЯࠎ઼̰Ϗޙϲ૱ሀĂ̶৺ዋ̷ّᅮࢋซ ˘Վଣ੅Ă߇ώࡁտͽณܑٙ଀̶ᇴෛࠎᚑࢦޘ޽ ᇾĂ̶ᇴ෸੼۰΃ܑᚑࢦޘ෸੼Ą ൏ᇋ̈́൏ᇋ඀ޘീณ̍׍ ֓ҹᇎ៭ณܑ

ĞBeck Depression Inventory-Ƕ, BDI-Ƕ; Beck, Steer,

& Brown, 1995ğ

В21ᗟҋ๱ณܑĂϡͽീؠᇎ៭඀ޘĄ ଐဩপኳ൏ᇋณܑ

ĞState-Trait Anxiety Inventory; Spielberger, Gorusch,

Lushene, Vagg, & Jacobs, 1983ğ

В40ᗟҋ๱ณܑĂ̶Ҿീؠଐဩ൏ᇋ඀ޘĞSAğ ᄃ൏ᇋপኳĞTAğĄ

࣒ࢎۍރ೻૵֙Ι̶ͯᙷീរ

ĞWisconsin card sorting test- Modified; Nelson, 1976ğ Nelsonࠎ˞ᆧΐᓜԖΞϡّ҃ᖎ̼ϤMilnerд 1963ѐ൴ण۞ރ೻૵֙Ι̶ͯᙷീរۍώĞLezak, 1995ğĂВֹϡ52ૺΙͯͽ̈́ഴ͌ו፬ᑩߎّ.ࡁտඕ ڍᙋ၁ΞડᏰᗝཧຫ๋ĞNelson, 1976ğĄ੃̶ր௚ ޽ᇾΒ߁:Ğ1ğ̶ᙷᓁᇴĞWCğĈ࣎९ΞԆј̶ᙷ ̝ᙷҾᇴϫĞ2ğ׽ેّ᏾ᄱĞWPEğĈ࣎९ٙѣ׽ ેّ᏾ᄱͅᑕ̝ᓁᇴĞ3ğܧ׽ેّ᏾ᄱĞWNPEğĈ ࣎९ٙѣܧ׽ેّ᏾ᄱͅᑕ̝ᓁᇴĞ4ğ፾প᏾ᄱ ĞWUEğĈ࣎९ٙѣܧֶᗞҒăԛېٕᇴณඈ̶ᙷࣧ ݋̶ֽᙷ̝᏾ᄱͅᑕᓁᇴĄ Ğˬğࡁտ඀Ԕ ࡁտ௡࣎९Ϥჟৠ૞ࡊᗁरֶDSM-IV෧ᕝ໤݋ ቁᄮ෧ᕝޢᖼ̬ણᄃࡁտĂдീរވ̚ᄲځࡁտϫ ീĄ ߉ീՎូֶԔࠎૄώྤफ़ణኘăރ೻૵֙Ιͯ ̶ᙷീរăᗬͩјˠം˧ീរ࣒ϒۍ̝ᄬ͛ം˧̶ ീរăাېᚑࢦޘෞҤᄃଐჰෞҤĄซҖ࣒ϒۍރ ೻૵֙Ι̶ͯᙷീរॡ߉ീ۰ᄃ࣎९ࢬ၆ࢬӱĂॸ ࢬ˯Ӕனαૺ̙Т௑ཱིপᇈј̶ĞԛېăᗞҒᄃᇴ ณğ̝ו፬ΙͯĂ఺αૺו፬Ιͯ΃ܑ̙Т۞̶ᙷ ᇾ໤Ă౺˭۞48ૺͅᑕΙͯυืϤ࣎९ֶፂ׎̚ߙ ࣎௑ཱིপᇈు˘૟ീរΙͯᕩᙷĂ߉ീ۰̙ਕ޽ጱ ᕩᙷఢ݋ĂΪਕа㒝၆᏾Ă༊࣎९ߙ˘̶ᙷాᜈϒ ቁᕩᙷ6ѨޢĂ߉ീ۰υืග̟ᖼೱ೩ϯ"ࣣ̖Ұٙ ֹϡ۞̶ᙷ͞ڱனд̙ዋϡ˞ĂҰࢋຐΩγ۞̶ᙷ ͞ڱ"Ăീរ඀Ԕ޺ᜈזٙѣΙ̶ͯᙷԆலĄ Β߁ٙѣീរᄃયסෞҤĂፋ࣎߉ീ࿅඀ࡗ˘ ࣎Η̈ॡĂώࡁտֶፂෞҤ༊ॡҖࠎ៍၅՟ѣ࣎९ ΍னি௢ٕ̙ЪүېڶĄ Ğαğྤफ̶़ژ Ğ1ğͽ፾ϲᇹώTᑭؠ(t test)ซҖ࣎९௡ᄃࡁտ ௡дѐ᛬ăିֈѐᇴăଐჰณܑͽ̈́ރ೻૵֙Ιͯ ̶ᙷീរЧࢍ̶޽ᇾ۞௡มमளّ҂រĄĞ2ğͽ࠹ ᙯ̶ژ̈́ుՎк̮ਫ਼ᕩ̶ژԱ΍ރ೻૵֙Ч੃̶޽ ᇾ࿰ീЯ̄ĄĞ3ğЯࠎাې̶௡ޢЧ௡ˠᇴྵ͌ͷ ᇴϫ̙˘ĂЯѩଳ൑ϓᇴ̶ژᗬΞᅊ׌ᇹώᑭؠ۞ ત-೎পκUᑭؠĞMann-Whitney U testğซҖ׌௡ াې̶ᙷ௡Ҿ(ᑭߤ۰ᄃܧᑭߤ۰)дЧี޽ᇾ۞௡ม मளᑭؠĂΒ߁ˠ˾ጯតีăଐჰ޽ᇾăাېᚑࢦ ޘ޽ᇾมͽ̈́ރ೻૵̶֙ᇴ޽ᇾĄ

ඕڍ

ૻ࢝াଈ۰ᄃ၆໰௡дᄬ͛ംથăᇎ៭ᄃ൏ᇋ ณܑăࡠጆο६ૻ࢝াณܑͽ̈́ރ೻૵֙Ι̶ͯᙷ ീរ۞πӮᇴăᇾ໤मăͽ̈́मளព඾ّ҂រඕڍ тܑ˘ٙЕĂ׌௡д֓ҹᇎ៭ณܑᄃপኳ൏ᇋณܑ ̶ᇴ྿ព඾मளĞt(42) = 11.958; p = .001ć t(42) = 12.386; p = .001ğĂពϯૻ࢝া௡ځពͧ၆໰௡ѣྵ ੼۞ᇎ៭ᄃ൏ᇋপኳĄЯࠎ׽ેّ᏾ᄱᄃܧ׽ેّ ᏾ᄱٕ፾প᏾ᄱ̝ม֭൑ព඾࠹ᙯĞr = .265, p = .082; r = .282, p = .064ğĂЯѩଳϡtᑭؠᑭീ׌௡д ރ೻૵֙Ι̶ͯᙷീរ۞ܑனĂ׌௡дീរЧี޽ ᇾ˯่ѣ׽ેّ᏾ᄱ޽ᇾĞ᏾ᄱ࣎ᇴğ྿ព඾म ளĂពϯૻ࢝াଈ۰ྵ၆໰௡ѣྵк۞׽ેّ᏾ ᄱĂ҃׌௡дܧ׽ેّ᏾ᄱ۞मளϏ྿ព඾Ąͽ׽ ેّ᏾ᄱͧத̶ࠎ׌௡Ğ׽ેّ᏾ᄱ/׽ેّ᏾ᄱΐ

˯ܧ׽ેّ᏾ᄱ̂ٺඈٺ50 % ٕ̈ٺ50 % ğซҖΙ ͞ᑭؠĂඕڍϺពϯ௡มमள྿ព඾Ğૻ࢝া௡Ĉ ၆໰௡׽ેّ᏾ᄱּͧ̂ٺ̈́ඈٺ50 %۰ = 31.8 % : 4.5 %, ɬ2_{= 5.5, p = .019}ğĄ׽ે᏾ᄱͧத෹࿅ٕඈٺ 50 % ۞࣎९ͽ൑ϓᇴតள̶ژᑭؠĂඕڍ׌௡дЧ ˠ˾ጯ޽ᇾăଐჰ޽ᇾăাېᚑࢦޘͽ̈́ᄬ͛ംથ ˯֭൑ព඾मளĄ ೻ϩત࠹ᙯ̶ژඕڍពϯᇎ៭ă൏ᇋপኳٕଐ ჰ൏ᇋᄃ׽ેّ᏾ᄱม࠰֭൑ព඾࠹ᙯхдĞr = .111, p = .481; r = .233, p = .128; r = .122, p = .430ğĄ ૟ˠ˾ጯតีᄃณ̶ܑᇴٸˢుՎк̮ਫ਼ᕩ̶ژĂ ඕڍពϯ่ѣ௡ҾĞૻ࢝া௡ᄃϒ૱၆໰௡ğ၆׽ ඾ّ᏾ᄱ޽ᇾྋᛖณ྿ព඾ĞF = 6.123, p = .018ğĂ Ξྋᛖតளณࠎ13%Ą૟ૻ࢝াᄃ၆໰௡̶Ҿֽ ࠻Ăд၆໰௡ѐ᛬Я̄Ξѣड़ྋᛖ׽ેّ᏾ᄱ޽ᇾ ۞តளĂΞྋᛖតளณࠎ34.5%ĞF = 10.01, p = .005ğĂҭдଈ۰௡݋൑ѩன෪Ą ૻ࢝ຍهাېᚑࢦޘĞYO̶ณ̶ܑᇴğᄃଐဩ ൏ᇋᄃ൏ᇋপኳ̶ᇴѣព඾࠹ᙯĞr = .437, p = .042; r = .422, p = .035ğĂҭাېᚑࢦޘ޽ᇾᄃރ೻૵֙Ι ̶ͯᙷീរЧี޽ᇾม࠰൑ព඾࠹ᙯĞኛ֍ܑ˟ğĄ ͽࡠጆο६ૻ࢝াณܑ̝াېᑭ८ܑ૟ૻ࢝া࣎९ ֶ͹ࢋাېซҖ̶௡ĂĶᑭߤ۰ķࠎͽᑭߤࠎ͹ࢋ াې۰ĂĶܧᑭߤ۰ķ͹ࢋͽ୻ሒͽّٕ̈́Խᑝ࠹ ᙯૻ࢝ຍهࠎ͹ࢋাېĂ̙Тૻ࢝াې჌ᙷĞᑭߤ ۰Ĉ14ˠĂܧᑭߤ۰Ĉ8ˠğдˠ˾ጯតีăଐჰณ ܑăাېᚑࢦޘณܑͽ̈́ރ೻૵֙Ι̶ͯᙷീរ޽ ᇾ۞൑ϓᇴតளᇴ̶ژඕڍтܑˬٙЕĂඕڍពϯ ่дރ೻૵֙Ι̶ͯᙷീរ۞፾প᏾ᄱ޽ᇾ྿ព඾ मளĞU = 24, p = .029ğĄ

੅ኢ

ώࡁտඕڍពϯӈֹග̟ᖼೱ೩ϯĂૻ࢝াଈ ۰̪൒ځពྵϒ૱၆໰௡࣎९дރ೻૵֙Ι̶ͯᙷ ീរѣՀк۞׽ેّ᏾ᄱĄૻ࢝াଈ۰ੵ˞׽ેّ ᏾ᄱ̝γĂд׎΁ീរ޽ᇾĞ̶ᙷᓁᇴăܧ׽ેّ ᏾ᄱͽ̈́፾প᏾ᄱğ֭Ϗᄃϒ૱ˠѣमளĂѩඕڍ ࣎९௡ᄃ၆໰௡ˠ˾ጯតีăീរ̶ᇴᄃតளᇴ̶ژඕڍ ܑ˘ ࣒ϒۍރ೻૵֙Ι̶ͯᙷീរ̶ᇴᄃাېᚑࢦޘณܑ̝೻ϩત࠹ᙯܼᇴ ܑ˟

ᄃధкА݈ࡁտඕڍ˘࡭ĞHead et al., 1989; Lucey et al., 1997; Okasha, 2000; Lacerda et al., 2003ğĄ

А݈ࡁտ۰Abbruzzeseඈˠд1993ă1995ѐ̈́ 1997ѐซҖ˘րЕࡁտĂࡁտඕڍពϯૻ࢝াଈ۰ дރ೻૵֙Ι̶ͯᙷീរ۞ܑன֭Ϗᄃϒ૱ଠט௡ ѣٙमளĂଈ۰֭՟ѣͧϒ૱ˠϚՀк۞׽ેّ᏾ ᄱĂࡁտ۰ଯኢౄјѩඕڍ۞ࣧЯࠎྍീរ۞׽ે ّ᏾ᄱᄃࡦγ઎݈ᗝཧΑਕĞdorso-lateral prefrontal cortexğྵѣᙯᓑĂ҃ૻ࢝াଈ۰۞ৠགྷঽந˯͹ࢋ Αਕ̙։ཝડ̙дࡦγ઎ᗝཧĂЯѩଯኢૻ࢝াଈ ۰дރ೻૵֙Ι̶ͯᙷീរ˯۞ܑனᑕྍᄃϒ૱ˠ ൑ளĄҭߏаᜪ࠹ᙯ͛ᚥޢ൴னĂᙯٺރ೻૵֙Ι ̶ͯᙷീរ۞׎΁ཝᇆညጯ۞ࡁտϺѣ̙Т۞൴ னĂLacerda (2003)ᄃLuceyĞ1997ğཝΑਕᇆညጯࡁ տ൴னΠෛ͸ăνீுᗝཧϩኳͽ̈́νԍ८ᄃૻ࢝ াଈ۰дރ೻૵֙Ι̶ͯᙷീរ۞׽ેّ᏾ᄱͅᑕ ѣᙯᓑĂϤѩଯኢރ೻૵֙Ι̶ͯᙷീរٙ஝ঘ۞ ཝડᑕྍ่̙݀ࢨٺࡦγ઎݈ᗝཧĞLezak, 1995; Lucey et al., 1997; Walsh & Darby, 1999; Lacerda et al., 2003; Demakis, 2003ğĄ ރ೻૵֙Ι̶ͯᙷീរ஝ঘז۞ᄮۢΑਕ࠹༊ ᇃھĂેҖΑਕߏ౵జᇃھᙋ၁ᄃރ೻૵֙Ι̶ͯ ᙷീរѣ੼ޘ࠹ᙯ۞ਕ˧ĂેҖΑਕঘ̈́ڦຍ˧ă ੃ጸă٩෪ޥ҂ăᖼೱᄃԺטඈΑਕĂ఺ֱΑਕᄃ ࡦγ઎݈ᗝཧͽγ۞׎΁ཝડાᙯܼ૜̷Ăּтீ ுᗝཧડăԍ८ᄃෛ͸Ğдᗝཧ-ϩኳ˭ਫ਼ྮ۞˯˭ ੈि็ᅍ።඀Էႊࢦࢋ۞֎ҒğĞLezak, 1995; Lucey et al., 1997; Walsh & Darby, 1999; Lacerda et al., 2003ğĂ҃ૻ࢝াଈ۰۞ᗝཧᄃϩኳ˭ਫ਼ྮΑਕள૱ ̏གྷజ̂ณࡁտ͚ٙ޺ĞSaxena et al., 1998, 2000; Stein, 2000; Lacerda et al., 2003ğĂЯѩૻ࢝াଈ۰Ξ ਕЯࠎ˯ࢗᄮۢΑਕ۞צຫ҃дރ೻૵֙Ι̶ͯᙷ ീរ˯ܑனྵ૱ˠमĄώࡁտඕڍពϯྫྷϒ૱௡࠹ ྵ̝˭Ăొ̶ૻ࢝া࣎९ӈֹ೩ֻγࠧੈि̪൒൑ ڱԼචീរܑனĂϺӈଈ۰൑ڱӀϡγдቢ৶೩੼ ᖼೱᄮۢనؠ۞ड़தĂពϯ׎ԺטΑਕள૱ĄА݈ ጯ۰ᄮࠎீுᗝཧצຫΞਕ΍ன۞ᅪᘣΒ߁൑ڱԺ טͽ̈́׽ેّ᏾ᄱĞStuss, 1986ğĂ߇ώࡁտඕڍព ϯૻ࢝াଈ۰ӔனԺטਕ˧ᅪᘣΞਕͅᑕྍᗝཧొ ̶Αਕள૱Ą ࿅Νৠགྷ͕நΑਕܑனᄃাې჌ᙷม۞ᙯܼϏ ѣ˘࡭۞ࡁտඕڍĂώࡁտඕڍពϯܧᑭߤ۰ͧᑭ ߤ۰Ϛͧྵк۞፾প᏾ᄱĂд׎΁޽ᇾ˯ᔵ൒Ϗ྿ ௚ࢍ˯۞ព඾मளĂҭߏܧᑭߤ௡˵้Шѣྵ੼۞ ᏾ᄱᇴͽ̈́Ԇјྵ͌۞̶ᙷᇴĂពϯܧᑭߤ௡дރ ೻૵֙Ι̶ͯᙷീរ۞ܑனྵҬͼͧᑭߤ௡मĂ఺ ඕڍᄃА݈ࡁտ˘࡭ĞGoodwin & Sher, 1992ğĄдώ ࡁտ̚ܧᑭߤ௡াې͹ࢋࠎ୻ሒাېͽ̈́ᄃّٕԽ ᑝѣᙯ۞ૻ࢝ຍهĂֶፂᓜԖ˯៍၅Ăͽૻ࢝ຍه ࠎ͹ࢋাې۞࣎९ĂЯࠎૻ࢝ຍه۞޺ᜈ̒ᕘĂٙ ͽͧྵ૱ٱީڦຍ˧൑ڱะ̚Ăଯീڦຍ˧ָ̙Ξ ਕߏౄјܧᑭߤ۰Ϛྵк፾প᏾ᄱͽ̈́ܧ׽ેّ᏾ ᄱ۞ࣧЯĄᔵ൒ώࡁտᑭរଈ۰ᗬͩം˧ീរ̚۞ ᇴфᇃޘ̶ീរᇴࣃĂଈ۰ਗ਼ࡦᄃึࡦᇴфᇃޘܑ னᄃ૱ˠ֭൑मளĂҭ̪ࣃ଀೩ᏹдϏֽࡁտ̚ΐ ˢՀԆፋ۞ڦຍ˧ീរĂϡͽᑭീ̙Тૻ࢝াې۞ ଈ۰ڦຍ˧ᄃેҖΑਕม۞ᙯᓑĄώࡁտ൴னাې ᚑࢦޘᄃރ೻૵֙Ι̶ͯᙷീរܑன՟ѣព඾ᙯ ᓑĂѩඕڍᄃА݈ࡁտඕڍ˘࡭ĞAbbruzzese et al., 1995; Gross-Isseroff et al., 1996; Okasha, 2000ğĄ൒҃ ఺࣎ඕڍݒᄃА݈ࡁտĞLucey et al., 1997ğӔன̙ ˘࡭۞ඕڍĂLuceyඈˠĞ1997ğ۞ࡁտពϯࡠጆο ६ૻ࢝াณܑ༊̚۞ૻ࢝ຍهณ̶͎ᇴᄃރ೻૵֙ ̶ᙷീរ۞ܑனѣځព࠹ᙯĄૻ࢝াېᚑࢦޘ၆ീ រܑனᇆᜩ۞ࡁտඕڍ̙˘࡭Ξਕᄃࡁտᇹώ۞ள ኳّѣᙯĂώࡁտૻ࢝াଈ۰ࡠጆο६ૻ࢝াณܑ ۞πӮ̶ᇴࠎ18̶ĂҲٺLuceyඈˠĞ1997ğ۞23 ̶Ăͽณܑᚑࢦޘඈ৺ડ̶Ăώࡁտ࣎९়ঽᚑࢦ ޘπӮࡗࠎ̚ඈĂ҃LuceyඈˠĞ1997ğࡁտᇹώ় ঽᚑࢦޘ݋้Шᚑࢦඈ৺Ą ώࡁտ൴னૻ࢝াଈ۰ͧϒ૱௡ځពѣྵ੼۞ ᇎ៭ଐჰᄃ൏ᇋّॾপኳĂͷૻ࢝ຍهณ̶͎ᇴᄃ ᑭߤ௡ᄃܧᑭߤ௡ત.೎পκVᑭؠඕڍ

൏ᇋଐჰᄃপኳ൏ᇋѣព඾ϒ࠹ᙯĂૻ࢝ຍهাې ෸ᚑࢦ۰൏ᇋّॾপኳ෸ૻͷ൏ᇋଐჰ෸੼Ąᇎ៭ ଐჰᄃ൏ᇋপኳдώࡁտϏពϯ΍၆ૻ࢝াଈ۰ે Җރ೻૵֙Ι̶ͯᙷീរѣᇆᜩĂ఺ඕڍᄃА݈ొ ̶ࡁտඕڍ˘࡭ĞAbbruzzese et al., 1995ğĂҭMoritz ඈˠĞ2001ğࡁտඕڍពϯᇎ៭ଐჰົᇆᜩૻ࢝া ଈ۰۞ރ೻૵֙Ι̶ͯᙷീរܑனĂдѩ͞ࢬࡁտ ඕڍ۞मளΞਕᄃଐჰෞҤ̍׍̙ТѣᙯĄMoritzඈ ˠଳϡణኘّᇎ៭ෞҤณܑĞ႔ѼႬ࿲ᇎ៭ෞҤณ ܑ, Hamilton Rating Scale for Depressionğүࠎ͹ࢋྤ फ̶़ژֶፂĂAbbruzzeseඈˠĞ1995ğଳϡ࿪ཝۍ෧ ᕝ̍׍ෞҤ׎ᇎ៭̈́൏ᇋ෧ᕝĂ҃ώࡁտଳϡҋ๱ ณܑĞ֓ҹᇎ៭ณܑğĂෞҤ̍׍۞मளΞਕᇆᜩࡁ տඕڍĂ֭ͷౄј̙Тࡁտඕڍ̝มᙱͽͧྵĄૄ ٺᓜԖপᇈ˯۞੼ВঽதĂૻ࢝াଈ۰۞ᇎ៭ଐ ჰă൏ᇋଐჰٕ൏ᇋّॾ้Шᄃৠགྷ͕நΑਕ̝ม ۞ᙯᓑ̪ࣃ଀Ϗֽซ˘ՎࡁտĄ ώࡁտඕڍពϯӈֹග̟ᖼೱ೩ϯĂૻ࢝াଈ ۰̪൒ѣͧϒ૱ˠՀк۞׽ેّ᏾ᄱĂពϯҬͼ೩ ֻγдੈि֭ϏԼච׎͕ШᖼೱᅪᘣĂ൒҃ซҖՀ ྎ௟۞ྤफ̶़ژޢ൴னĂᔵ൒ૻ࢝া௡ଈ۰ᄃϒ૱ ௡д׽ેّ᏾ᄱͧத˯௚ࢍᑭؠ྿ព඾मளĂҭߏ ૻ࢝া௡༊่̚ѣˬ̶̝˘۞ଈ۰൑ڱଂ೩ϯੈि ̚צৈĞ׽ેّ᏾ᄱͧதд50%ͽ˯ğĂ׎΁෹࿅Η ᇴ۞ૻ࢝া࣎९д׽ેّ᏾ᄱͧத޽ᇾ˯֭ϏӔன ᅪᘣĂពϯૻ࢝াଈ۰གྷϤ೩ֻγࠧੈिԼච׽ે ّ᏾ᄱ۞ਕ˧ளኳّࣃ଀ซ˘ՎࡁտĄಶ͕நڼᒚ ඉர۞҂ณֽᄲĂ࿅Νొ̶ڼᒚଳפ೩ֻγдᖼೱ ቢ৶ЋဦԼචଈ۰׽ેҖࠎĂֶፂώࡁտඕڍĂొ Њଈ۰൑ڱଂ೩ֻ఺჌γдቢ৶̚צৈĂޙᛉᓜԖ ̍ү۰Ξଳϡ࣒ϒۍރ೻૵֙ീរүࠎᎡᏴ̍׍Ă ෞҤૻ࢝াଈ۰ᖣϤγд೩ϯᖼೱቢ৶ԼචҖࠎ۞ ਕ˧Ă੫၆࣎९ਕ˧۞࣎ҾमளֽᏴፄপؠ఍ཉඉ ரĄώࡁտࠎ݈ᔌّࡁտĂ׎ࢨטࠎᇹώྵ̈Ăͷ ৿ͻ̙೩ֻᖼೱੈि۞၆໰௡ĂЯѩ൑ڱ଀ۢ఺჌ γдੈि၆ૻ࢝াଈ۰׽ેҖࠎ۞Լච඀ޘĂ࿰ࢍ дϏֽࡁտ૟ᕖ̂ᇹώ֭ᆧΐ̙೩ֻᖼೱੈि۞ଠ ט௡Ăซ˘Վଣ੅఺࣎યᗟĄ ࣃ଀˘೩۞ĂώࡁտТॡពϯ࣒ϒۍރ೻૵֙ Ι̶ͯᙷീរдᓜԖᏊᝥ۞Ξϡّ੼Ăϫ݈ᓜԖ૱ ֹϡϤHeatonͩٙ൴ण۞128Ιͯᇾ໤ۍĂ߉ീॡม ˯࿅ܜٽౄјଈ۰ଐჰ˯۞൭ࡴᄃ̙щĂͷෞ̶ր ௚࿅ޘኑᗔ૱ֹ߉ീ۰୕ً̝ՎĄ̝ͅĂώࡁտٙ ଳϡ۞࣒ϒۍރ೻૵֙Ι̶ͯᙷീរĂ߉ീॡม ൺă੃̶ր௚ಏ৷̼Ăͷܲ঻ᓜԖ̶ژड़ϡ੼۞޽ ᇾĄ఺ֱ޽ᇾ׍ѣઍീૻ࢝াଈ۰Ժטਕ˧ָ̙ă ͕Шనؠᖼೱӧᙱͽ̈́৿ͻᇅّඈᄮۢᅪᘣ۞Α ਕĂ߇ޙᛉ઼̰ᓜԖ̍үٕࡁտ۰дซҖૻ࢝াଈ ۰۞ৠགྷ͕நᏊᝥΞଳϡѩ࣒ϒۍീរۍώĄ

ᄫᔁ

ώࡁտٚᄋ઼ࡊົࡁտࢍ൪९ĶNSC92-2413-H-002-008ķ̝ొ̶ྤӄ଀ͽԆјĂপѩ࡭ᔁĄ

ણ҂͛ᚥ

Abbruzzese, M., Ferri, S., & Scarone, S. (1995). Wisconsin Card Sorting Test performance in obses-sion-compulsive disorder: No evidence for involve-ment of dorsolateral prefrontal cortex. Psychiatry

Research, 58, 37-43.

Abbruzzese, M., Ferri, S., & Scarone, S. (1997). The selective breakdown of frontal functions in patients with obsessive-compulsive disorder and in patient with schizophrenia: A double dissociation experimen-tal funding. Neuropsychologia, 35, 907-912.

Beck, A. T., Steer, R. A. & Brown, G. (1995). Manual

for the Beck Depression Inventory-Ƕ. San Antonio,

TX: The Psychological Corporation.

Chacko, R. C., Corbin, M. A., & Harper, R. G. (2000). Acquired obsession-compulsive disorder associated with basal ganglia lesions. The Journal of Neuropsychiatry

and Clinical Neurosciences, 2, 267-272.

Demakis, G. J. (2003). A meta-analytic review of the sensitiveity of the Wisconsin Card Sorting Test to frontal and lateralized frontal brain damage.

Neuropsychology, 17, 255-264.

Gambini, O., Abbruzzese, M., & Scarone, S. (1993). Smooth pursuit and saccadic eye movement and Wisconsin Card Sorting Test performance in obses-sive-compulsive disorder. Psychiatry Rearsch, 48, 191-200.

Goodman, W. K., Price, L. H., & Rasmussen, S. A. (1989). The Yale-Brown Obsessive Compulsive Scale (Y- BOCS): Part I, development, use and reliability.

Archives of General Psychiatry, 46, 1006-1011.

Goodman, W. K., Price, L. H., & Rasmussen, S. A. (1989). The Yale-Brown Obsessive Compulsive Scale (Y- BOCS): Part II, effectiveness. Archives of

General Psychiatry, 46, 1012-1016.

set-Behavioral Assessment, 14, 81-92.

Greisberg, S. & McKay, D. (2003). Neuropsychology of obsessive-compulsive disorder: A review and treat-ment implications. Clinical Psychology Review, 23, 95-117.

Gross-Isseroff, R., Sasson, Y., Voet, H., Hendler, T., Luca-Haimovici, K., Kandel-Sussman, H., & Zohar, J. (1996). Alternation learning in obsessive-compul-sive disorder. Biological Psychiatry, 39, 733-738. Head, D., Bolton, D., & Hymas, N. (1989). Deficit in

cognitive shifting ability in patient with obsessive-compulsive disorder. Biological Psychiatry, 25, 929-937.

Lacerda, A. L. T., Dalgalarrondo, P., Caetano, D., Hass, G. L., Camargo, E. E., & Keshavan, M. S. (2003). Neuropsychological performance and regional cere-bral blood flow in obsessive-compulsive disorder.

Progress in Neuro - Psychopharmacology & Biological Psychiatry, 27, 657-665.

Lucey, J. V., Burness, C. E., Costa, Dc., Gacinovic, S., Pilowsky, L. S., Ell, P. J., Marks, I. M., Kerwin, R. W. (1997). Wisconsin Card Sorting Test (WCST) errors and cerebral blood flow in obsessive-compulsive dis-order. British Journal of Medical Psychology, 70, 403-411.

Lezak, M. D. (1995).Neuropsychological assessment (3rd ed.). NY: Oxford University Press.

Mataix-Cols, D., Junque, C., Sanchez-Turet, M., Vallrjo, J., Verger, K., & Barriors, M. (1999). Neuropsychological function in a subclinical obsessive-compulsive sam-ple. Biological psychiatry, 45, 898-904.

Moritz, S., Christiane, B., Martin, K., Dirk, J., Susanne, F., Aenne, B., & Iver, H. (2001). Impact of comorbid depressive symptoms on neuropsychological

per-of Abnormal Psychology, 110, 653-657.

Nelson, H. M. (1976). A modified card sorting test sen-sitive to frontal lobe defects. Cortex, 12, 313-24. Okasha, A. (2000). Cognitive dysfunction in OCD. Acta

Psychiatrica Scandinavica, 101, 281-285.

Otto, M. W. (1992). Normal and abnormal information processing. The Psychiatric Clinics of North

America, 15, 825-847.

Saxena, S., Brody, A. L., Schwartz, J. M., & Baxter, L. R. (1998). Neuroimaging and frontal -subcortical cir-cuitry in obsessive-compulsive disorder. British

Journal of Psychiatry, 173, 26-37.

Saxena, S., & Rauch, S. L. (2000). Functional neu-roimaging and the neuroanatomy of obsessive-com-pulsive disorder. The Psychiatric Clinics of North

America, 23, 563-585.

Spielberger, C. D., Gorusch, R. L., Lushene, R., Vagg, P. R. & Jacobs, G. A. (1983). Manual for the State-Trait

Anxiety Inventory. Palo Alto, California: Consulting

Psychologists Press.

Stein, D. J. (2000). Advances in the neurobiology of obsessive-compulsive disorder. The Psychiatric

Clinics of North America, 23, 545-561.

Stuss, D. T. & Benson, D. F. (1986). The frontal lobes. New York: Raven Press.

Walsh, K. & Darby, D. (1999). Neuropsychology: A

clinical approach. Edinburgh: Churchill Livingstone

Press.

ܐቇќІĈ2004ѐ11͡10͟ Ԇј࣒ϒĈ2005ѐ05͡18͟

The Effect of Obsessire-compulsive Disorder on Performant of the

wisconsin Card sorting Test-Modified

Hao-Ren Cheng

1

_{and Mau-Sun Hua}

2

1_{Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University}

2_{Department of Psychology, National Taiwan University}

Abstract

Objective: The issue of whether patients with obsessive-compulsive disorder (OCD) have mental-shifting difficulty

mainly reflected by significant perseverative errors on the Wisconsin Card Sorting Test has been contro-versial in the literature. Methodological problems might contribute to these discrepant findings. The pres-ent study re-examined this issue with a minimization of methodological defects, and further determined if patients who do have mental-shifting difficulty can benefit from an external cue for mental-shifting.

Method: Twenty-two OCD patients and 22 mentally and neurologically healthy controls were recruited,

matched by age, sex and educational levels. All participants completed the Wisconsin card sort-ing test- Modified (WCST-M), the verbal intelligence subtests of the Wechsler Adult Intelligent Scale-Revised[AC4] , the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI).

Results: The data analysis showed that patients did not perform significantly different from their normal

counterparts on the WCST-M with the exception of perseverative errors. There was no remark-able relationship between the severity of OCD and scoring indices of the WCST-M.

Conclusion: Our patients with OCD did evidence mental-shifting deficit reflected by remarkable perseverative errors

on the WCST-M. Based on this result, we suggest that at least for some of the patients with OCD, the con-ventional psychotherapy with providing external cue might not be adequate.

Key words: Obsessive-Compulsive Disorder; the Wisconsin Card Sorting Test- Modified; Frontal Lobe;