Bartz Jennifer A, Hollander Eric
Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, New York, NY 10029, USA.
Prog Neuropsychopharmacol Biol Psychiatry. 2006 May;30(3):338-52. doi: 10.1016/j.pnpbp.2005.11.003. Epub 2006 Feb 7.
Obsessive-compulsive disorder (OCD) is classified as an anxiety disorder in the DSM-IV-TR [American Psychiatric Association, 2000. Diagnostic and statistical manual of mental disorders, Fourth ed., rev. Washington, DC: Author]; however, the notion of a spectrum of obsessive-compulsive (OC) related disorders that is comprised of such disparate disorders as OCD, body dysmorphic disorder, certain eating disorders, pathological gambling, and autism, is gaining acceptance. The fact that these disorders share obsessive-compulsive features and evidence similarities in patient characteristics, course, comorbidity, neurobiology, and treatment response raises the question of whether OCD is best conceptualized as an anxiety or an OC spectrum disorder. This article reviews evidence from comorbidity and family studies, as well as biological evidence related to neurocircuitry, neurotransmitter function, and pharmacologic treatment response that bear on this question. The implications of removing OCD from the anxiety disorders category and moving it to an OC spectrum disorders category, as is being proposed for the DSM-V, is discussed.
强迫症（OCD）在《精神疾病诊断与统计手册》第四版修订版（DSM-IV-TR）[美国精神病学协会，2000年。《精神疾病诊断与统计手册》，第四版，修订版。华盛顿特区：作者]中被归类为焦虑症；然而，由强迫症（OC）相关障碍组成的谱系概念正逐渐被接受，这些障碍包括强迫症、躯体变形障碍、某些饮食失调、病态赌博和自闭症等不同的疾病。这些疾病具有强迫特征，并且在患者特征、病程、共病、神经生物学和治疗反应方面存在相似证据，这就引发了一个问题：强迫症最好被概念化为焦虑症还是OC谱系障碍。本文回顾了来自共病和家族研究的证据，以及与神经回路、神经递质功能和药物治疗反应相关的生物学证据，这些证据都与这个问题相关。文中还讨论了如《精神疾病诊断与统计手册》第五版（DSM-V）所提议的，将强迫症从焦虑症类别中移除并归入OC谱系障碍类别的影响。
