執着 障害: 診断 と 治療 の 進歩
Matthew E Hirschtritt1, Michael H Bloch2, Carol A Mathews3
1Department of Psychiatry, University of California, San Francisco.
JAMA
|April 7, 2017
まとめ
執着性障害 (OCD) の治療の進歩には,オンライン認知行動療法と,治療に抵抗する症例の新しい選択肢が含まれています. セロトニン再吸収阻害剤は 强迫性障害の第一選択です
科学分野:
- 神経科学と精神医学
- 臨床心理学
背景:
- 執着性障害 (OCD) は一般的な神経精神疾患で,主治医では診断と治療が不足していることが多い.
- 生涯の流行率は1%から3%で,公衆衛生上の重大な懸念を示しています.
研究 の 目的:
- 成人のOCDのスクリーニング,診断,治療の最新版のレビューを提供するためです.
- 新興と確立した治療方法に関する現在の証拠を統合する.
主な方法:
- 2011年から2016年の間に発表されたランダム化制御試験 (RCT),メタ解析,および体系的レビューの体系的レビュー.
- PubMed,EMBASE,PsycINFOで実施された検索で,より高いレベルの証拠が優先される.
主要な成果:
- DSM-5は強迫性障害の分類を改定し,不安障害から分離し,ティクと洞察のための特異性を追加しました.
- コンピュータによる認知行動療法 (CBT) は,強迫性障害の症状を軽減する効果を示しています.
- セロトニン再吸収阻害剤 (SSRI) は第一線薬剤療法であり,神経麻痺薬,深部脳刺激薬,神経外科手術は治療に抵抗する強迫性障害の選択肢である.
結論:
- コンピュータベースのCBTは OCD治療のアクセシビリティと有効性において 重要な進歩を示しています
- CBTとSSRIが主な戦略である一方で,新種の治療法がOCDの耐性症例に登場しています.
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