Torres Albina R, Prince Martin J, Bebbington Paul E, Bhugra Dinesh K, Brugha Traolach S, Farrell Michael, Jenkins Rachel, Lewis Glyn, Meltzer Howard, Singleton Nicola
Department of Neurology and Psychiatry, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Distrito de Rubião Jr., Botucatu (São Paulo), Brazil, 18618-970.
Psychiatr Serv. 2007 Jul;58(7):977-82. doi: 10.1176/ps.2007.58.7.977.
For several reasons, many individuals with obsessive-compulsive disorder (OCD) do not seek treatment. However, data on treatment seeking from community samples are scant. This study analyzed service use by adults with OCD living in private households in Great Britain.
Data from the British Survey of Psychiatric Morbidity of 2000, in which 8,580 individuals were surveyed, were analyzed. Service use was compared for those with OCD, with other neuroses, with different subtypes of OCD (only obsessions, only compulsions, or both), and with OCD and comorbid neuroses.
Persons with OCD (N=114) were more likely than persons with other neuroses (N=1,395) to be receiving treatment (40% compared with 23%, p<.001). However, those with OCD alone (N=38) were much less likely than those with OCD and a comorbid disorder to be in treatment (14% compared with 56%, p<.001). In the previous year, 9.4% of persons with OCD had seen a psychiatrist and 4.6% had seen a psychologist. Five percent were receiving cognitive-behavioral therapy, 2% were taking selective serotonin reuptake inhibitors, and 10% were taking tricyclics.
Most persons with OCD were not in contact with a mental health professional, and apparently very few were receiving appropriate treatments. Very few persons with noncomorbid OCD were receiving treatment. Individuals with OCD who are in treatment may not be disclosing their obsessions and compulsions and may be discussing other emotional symptoms, leading to inappropriate treatment strategies. Public awareness of OCD symptoms should be raised, and primary care professionals should inquire about them with all patients who have depressive or anxiety disorders.
由于多种原因，许多强迫症（OCD）患者未寻求治疗。然而，来自社区样本的治疗寻求数据却很少。本研究分析了居住在英国私人家庭中的成年强迫症患者的服务利用情况。
对2000年英国精神疾病发病率调查中的数据进行分析，该调查共对8580人进行了调查。比较了强迫症患者、其他神经症患者、强迫症不同亚型（仅强迫观念、仅强迫行为或两者皆有）患者以及患有强迫症合并其他神经症患者的服务利用情况。
强迫症患者（N = 114）比其他神经症患者（N = 1395）更有可能接受治疗（40% 对比23%，p <.001）。然而，单纯患有强迫症的患者（N = 38）比患有强迫症合并其他疾病的患者接受治疗的可能性要小得多（14% 对比56%，p <.001）。在前一年，9.4% 的强迫症患者看过精神科医生，4.6% 的患者看过心理医生。5% 的患者接受认知行为疗法，2% 的患者服用选择性5-羟色胺再摄取抑制剂，10% 的患者服用三环类药物。
大多数强迫症患者未与心理健康专业人员接触，显然很少有人接受适当治疗。非合并其他疾病的强迫症患者接受治疗的人数极少。正在接受治疗的强迫症患者可能未透露其强迫观念和强迫行为，而是在讨论其他情绪症状，从而导致不适当的治疗策略。应提高公众对强迫症症状的认识，初级保健专业人员应对所有患有抑郁或焦虑症的患者询问相关症状。
