Husted David S, Shapira Nathan A
Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL 32610-0256, USA.
CNS Spectr. 2004 Nov;9(11):833-47. doi: 10.1017/s109285290000225x.
This article provides an overview of the etiology, epidemiology, and first-line treatment options for obsessive-compulsive disorder (OCD). The subject of treatment-resistant and treatment-refractory OCD is then discussed, including a definition of these often-debated terms, and the latest treatment options delineated. This includes a review of the latest research concerning the pharmacological agents that have been studied as monotherapy or augmenting agents for the treatment of OCD, the use of experimental medications and procedures, treatment with reversible, minimally invasive procedures, such as vagal nerve stimulation and transcranial magnetic stimulation, invasive but the potentially reversible deep brain stimulation, and irreversible lesioning with ablative psychosurgery. A discussion of the role of psychotherapy in the treatment of OCD is also included.
本文概述了强迫症（OCD）的病因、流行病学及一线治疗方案。接着讨论了难治性和治疗抵抗性强迫症这一主题，包括对这些经常被讨论的术语的定义，以及所描述的最新治疗方案。这包括对最新研究的综述，这些研究涉及已被研究作为强迫症单一疗法或增效剂的药物制剂、实验性药物和程序的使用、采用迷走神经刺激和经颅磁刺激等可逆性微创程序的治疗、侵入性但可能可逆的深部脑刺激，以及采用切除性精神外科手术进行的不可逆损伤。本文还讨论了心理治疗在强迫症治疗中的作用。
