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强迫症

最后审阅: 4 Sep 2024
最后更新: 22 Jul 2022

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
完整详情

其他诊断因素

  • 男性
完整详情

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)
完整详情

诊断性检查

首要检查

  • 无初始检查
完整详情

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)
完整详情

治疗流程

急症处理

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
Phillip J. Seibell

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
Stefano Pallanti

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
Silvia Bernardi

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
Megan Hughes-Feltenberger

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
Eric Hollander

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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