Department of Psychology, Binghamton University, Binghamton, NY 13902-6000, USA.
J Clin Sleep Med. 2011 Jun 15;7(3):307-9. doi: 10.5664/JCSM.1080.
Individuals with treatment-resistant obsessive compulsive disorder (OCD) have elevated rates of delayed sleep phase. This report describes a patient with severe OCD who had failed prior trials of pharmacotherapy and psychotherapy, and whose symptoms were associated with delayed bedtimes and delays in the time she initiated her nighttime compulsions.
Case report.
A 54 year-old woman with OCD kept sleep/symptom logs as an adjunct to traditional cognitive-behavioral therapy for OCD. At presentation, she reported habitual bedtime = 06:00, wake time = 13:00, sleep latency ' 5 min, and total sleep time = 6.5-7.5 h. Later time of initiating her compulsions was associated with longer time performing the compulsions (r = 0.86, p < 0.001). Cognitive-behavioral therapy with adjunctive chronotherapy was associated with substantial improvement.
OCD patients with nighttime compulsions may receive light exposure that results in delayed sleep times/circadian phase. Chronotherapy may enhance outcomes for refractory OCD patients, particularly those who perform compulsions at night.
患有治疗抵抗性强迫症（OCD）的个体睡眠相位延迟率升高。本报告描述了一名患有严重 OCD 的患者，其先前的药物治疗和心理治疗均失败，其症状与晚睡和夜间强迫开始时间延迟有关。
病例报告。
一名 54 岁女性患有 OCD，她将睡眠/症状日志作为传统认知行为疗法治疗 OCD 的辅助手段。就诊时，她报告的习惯就寝时间为 06:00，醒来时间为 13:00，睡眠潜伏期> 5 分钟，总睡眠时间为 6.5-7.5 小时。开始强迫行为的时间较晚与完成强迫行为的时间较长相关（r = 0.86，p < 0.001）。认知行为疗法辅以时间疗法与显著改善相关。
夜间有强迫行为的 OCD 患者可能会接受导致睡眠延迟/昼夜节律相位延迟的光照。时间疗法可能会增强难治性 OCD 患者的治疗效果，特别是那些夜间进行强迫行为的患者。
