Murphy Dennis L, Timpano Kiara R, Wheaton Michael G, Greenberg Benjamin D, Miguel Euripedes C
Laboratory of Clinical Science, NIMH Intramural Research Program, Bethesda, Maryland 20892, USA.
Dialogues Clin Neurosci. 2010;12(2):131-48. doi: 10.31887/DCNS.2010.12.2/dmurphy.
Obsessive-compulsive disorder (OCD) is a clinical syndrome whose hallmarks are excessive, anxiety-evoking thoughts and compulsive behaviors that are generally recognized as unreasonable, but which cause significant distress and impairment. When these are the exclusive symptoms, they constitute uncomplicated OCD. OCD may also occur in the context of other neuropsychiatric disorders, most commonly other anxiety and mood disorders. The question remains as to whether these combinations of disorders should be regarded as independent, cooccurring disorders or as different manifestations of an incompletely understood constellation of OCD spectrum disorders with a common etiology. Additional considerations are given here to two potential etiology-based subgroups: (i) an environmentally based group in which OCD occurs following apparent causal events such as streptococcal infections, brain injury, or atypical neuroleptic treatment; and (ii) a genomically based group in which OCD is related to chromosomal anomalies or specific genes. Considering the status of current research, the concept of OCD and OCD-related spectrum conditions seems fluid in 2010, and in need of ongoing reappraisal.
强迫症（OCD）是一种临床综合征，其特征是出现过度的、引发焦虑的想法以及强迫行为，这些行为通常被认为不合理，但会导致严重的痛苦和功能损害。当这些是唯一症状时，就构成了单纯性强迫症。强迫症也可能出现在其他神经精神障碍的背景下，最常见的是其他焦虑和情绪障碍。问题仍然在于，这些障碍的组合应被视为独立的、同时出现的疾病，还是作为病因尚未完全明了的强迫症谱系障碍的不同表现形式，具有共同的病因。这里还进一步考虑了两个基于潜在病因的亚组：（i）基于环境的亚组，其中强迫症发生在明显的因果事件之后，如链球菌感染、脑损伤或非典型抗精神病药物治疗；（ii）基于基因组的亚组，其中强迫症与染色体异常或特定基因有关。考虑到当前研究的状况，在2010年，强迫症及与强迫症相关的谱系疾病的概念似乎并不固定，需要持续重新评估。
