小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 强迫观念
- 强迫行为
- 感官现象
- 分裂型人格障碍
- 抽动障碍
- 运动协调性差
- 感知觉障碍
- 顺序完成复杂运动任务困难
其他诊断因素
- 男性
危险因素
- OCD 家族史
- PANDAS（与链球菌感染相关的儿童自身免疫性神经精神疾病）
- 妊娠
- 男性（早发、病程更长、治疗抵抗）
- 强迫出现的频率增加（治疗抵抗）
- 首发年龄早（治疗抵抗）
- 强迫症的住院史（治疗抵抗）
- 分裂型人格障碍（治疗抵抗）
- 抽动障碍（治疗抵抗）
- 特定或弥散性脑结构异常（治疗抵抗）
诊断性检查
首要检查
- 无初始检查
需考虑的检查
- DSM 临床定式访谈（SCID）
- 耶鲁-布朗强迫量表（Y-BOCS）
- 临床疗效总评量表（CGI）
治疗流程
症状轻度至中度：无人格障碍或分离症状
重度症状或伴人格障碍/分离症状共病
撰稿人
作者
Phillip J. Seibell, MD, FAPA
OCD and Anxiety Psychiatry of Westchester, P.C.
Hawthorne
NY
利益声明
PJS has received honoraria from Slack, Inc., for guest editing an issue on OCD.
Stefano Pallanti, MD, PhD
Professor of Psychiatry
Institute of Neuroscience
Florence
Italy
利益声明
SP declares that he has no competing interests. SP is an author of several references cited in this topic.
Silvia Bernardi, MD
Project Manager
New York State Psychiatric Institute
Columbia University
New York
NY
利益声明
SB receives research sponsorship from NYSPI, APA, and the Brain & Behavior Research Foundation. SB is also a board member of the New York council on Problem Gambling. SB is an author of a reference cited in this topic.
Megan Hughes-Feltenberger, PhD
Assistant Professor of Psychology in Psychiatry
Assistant Director of Education for Psychology
Weill Cornell Medical College
Assistant Attending Psychologist
NewYork-Presbyterian Hospital
New York
NY
利益声明
MHF declares that she has no competing interests.
Eric Hollander, MD
Clinical Professor of Psychiatry and Behavioral Sciences
Director
Compulsive, Impulsive and Autism Spectrum Disorder Program
Albert Einstein College of Medicine
Montefiore Medical Center
New York
NY
利益声明
EH has received research grants from, and has consulted for, Roche, GW Pharmaceuticals, and Bixink.
鸣谢
The authors would like to gratefully acknowledge Dr Ashley Braun, a previous contributor to this topic. AB declares that she has no competing interests.
同行评议者
Juliana Belo Diniz, MD
Psychiatrist
Department and Institute of Psychiatry
Clinical Hospital
University of Sao Paulo Medical School
Sao Paulo
Brazil
利益声明
JBD declares that she has no competing interests.
Amit Nigam, MBBS, MRCPsych
Specialist Registrar in Forensic Psychiatry and Honorary Research Worker
National OCD Service
Queen Elizabeth II Hospital
Welwyn Garden City
Forensic Psychiatrist
West London Mental Health NHS Trust
London
UK
利益声明
AN declares that he has no competing interests.
鉴别诊断
- 强迫性人格障碍（OCPD）
- 躯体变形障碍（BDD）
- 躯体症状障碍
更多 鉴别诊断指南
- 精神障碍诊断与统计手册第 5 版修订版（DSM-5-TR）
- 脑深部电刺激用于强迫性障碍
更多 指南患者教育信息
强迫症
更多 患者教育信息
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