Lochner Christine, Stein Dan J
MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa.
Harv Rev Psychiatry. 2003 May-Jun;11(3):113-32. doi: 10.1080/10673220303949.
Significant advances have been made in characterizing the phenomenology and psychobiology of obsessive-compulsive disorder (OCD) in recent years. In many ways, such advances suggest a conceptualization of OCD as a relatively homogeneous neuropsychiatric entity, underpinned by particular mechanisms that manifest in universal symptoms. Nevertheless, some data have pointed to the heterogeneity of this disorder. A computerized literature search (MEDLINE: 1964-2001) was used to collect studies addressing the heterogeneity of OCD. In addition, reviews of the phenomenology, psychobiology, family studies, and treatment of OCD were examined in an attempt to collate data addressing this issue. There is a growing consensus that some subtypes of OCD are valid and provide a useful means of integrating data on its symptomatology, neurobiology, and treatment response; for example, OCD with comorbid tics is characterized by earlier onset, a particular range of OCD symptoms, and worse response to selective serotonin reuptake inhibitors. The heterogeneity of OCD has important clinical and research implications.
近年来，在描述强迫症（OCD）的现象学和心理生物学方面取得了重大进展。在许多方面，这些进展表明将强迫症概念化为一种相对同质的神经精神实体，由特定机制支撑，这些机制表现为普遍症状。然而，一些数据指出了这种疾病的异质性。通过计算机文献检索（MEDLINE：1964 - 2001）收集了关于强迫症异质性的研究。此外，还审查了强迫症的现象学、心理生物学、家族研究和治疗方面的综述，试图整理解决该问题的数据。越来越多的人达成共识，即某些强迫症亚型是有效的，并且为整合其症状学、神经生物学和治疗反应的数据提供了有用的方法；例如，伴有共病抽动的强迫症具有发病较早、特定范围的强迫症症状以及对选择性5-羟色胺再摄取抑制剂反应较差的特点。强迫症的异质性具有重要的临床和研究意义。
