Bejerot Susanne
Karolinska Institute, Stockholm, Sweden.
Autism. 2007 Mar;11(2):101-10. doi: 10.1177/1362361307075699.
This article focuses on the possibility that autism spectrum disorder (ASD: Asperger syndrome, autism and atypical autism) in its milder forms may be clinically important among a substantial proportion of patients with obsessive-compulsive disorder (OCD), and discusses OCD subtypes based on this proposition. The hypothesis derives from extensive clinical experience of OCD and ASD, and literature searches on MEDLINE. Neuropsychological deficits are more common in OCD than in panic disorder and depression. Moreover, obsessive-compulsive and schizotypal personality disorders are over-represented in OCD. These may constitute mis-perceived clinical manifestations of ASD. Furthermore, repetitive behaviours and hoarding are common in Asperger syndrome. It is suggested that the comorbidity results in a more severe and treatment resistant form of OCD. OCD with comorbid ASD should be recognized as a valid OCD subtype, analogous to OCD with comorbid tics. An odd personality, with paranoid, schizotypal, avoidant or obsessive-compulsive traits, may indicate these autistic dimensions in OCD patients.
本文关注的是，在相当一部分强迫症（OCD）患者中，轻度形式的自闭症谱系障碍（ASD：阿斯伯格综合征、自闭症和非典型自闭症）在临床上可能具有重要意义，并基于这一观点讨论了强迫症的亚型。该假设源于对强迫症和自闭症谱系障碍的广泛临床经验，以及对MEDLINE的文献检索。神经心理学缺陷在强迫症中比在惊恐障碍和抑郁症中更为常见。此外，强迫型和分裂型人格障碍在强迫症中所占比例过高。这些可能构成自闭症谱系障碍的误诊临床表现。此外，重复行为和囤积行为在阿斯伯格综合征中很常见。有人认为，这种共病会导致一种更严重且难治的强迫症形式。合并自闭症谱系障碍的强迫症应被视为一种有效的强迫症亚型，类似于合并抽动症的强迫症。具有偏执、分裂型、回避型或强迫型特质的古怪人格，可能表明强迫症患者存在这些自闭症维度。
