强迫症:诊断和治疗方面的进展
Matthew E Hirschtritt1, Michael H Bloch2, Carol A Mathews3
1Department of Psychiatry, University of California, San Francisco.
JAMA
|April 7, 2017
概括
强迫症治疗的进展包括在线认知行为疗法和治疗耐药病例的新选择. 选择性血清素再吸收抑制剂仍然是强迫症的第一线选择.
科学领域:
- 神经科学与精神病学
- 临床心理学
背景情况:
- 强迫症 (OCD) 是一种普遍的神经精神疾病,在初级保健中经常被诊断和治疗不足.
- 终身患病率在1%至3%之间,这突显出严重的公共卫生问题.
研究的目的:
- 提供成年人强迫症查,诊断和治疗的最新评估.
- 综合有关新兴和已确定的治疗方法的现有证据.
主要方法:
- 2011年至2016年间发表的随机对照试验 (RCT),元分析和系统审查的系统审查.
- 在PubMed,EMBASE和PsycINFO进行搜索,优先考虑更高级别的证据.
主要成果:
- DSM-5修订了强迫症的分类,将其与焦虑症分开,并增加了特征和洞察力.
- 计算机交付的认知行为疗法 (CBT) 在减少强迫症症状方面表现出有效性.
- 选择性血清素再吸收抑制剂 (SSRI) 是第一线药物治疗;神经敏药物,深度大脑刺激和神经外科手术是治疗耐药性强迫症的选择.
结论:
- 基于计算机的CBT在强迫症治疗的可及性和有效性方面取得了重大进展.
- 虽然CBT和SSRI仍然是主要的策略,但对于耐强迫症病例而言,新的治疗方法正在出现.
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