Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Curr Opin Psychiatry. 2011 Nov;24(6):541-8. doi: 10.1097/YCO.0b013e32834abb7f.
In spite of advances in the understanding and treatment of obsessive-compulsive disorder (OCD), for most patients some symptoms persist even after therapeutic intervention. Another large subgroup does not seek treatment at all, particularly due to shame or fear of stigma. The treatment gap in OCD is large and self-help is increasingly seen as a low-threshold form of intervention for individuals with minor symptoms or who are currently treatment-reluctant. Our review summarizes the expanding but still small literature on self-help and Internet interventions for OCD and provides advice on how to conduct (Internet) studies on self-help. Strategies to deal with methodological problems that notoriously plague Internet research are discussed.
Despite methodological limitations inherent in most studies considered for the current review, as well as the unreplicated nature of some of the more recent findings, self-help tools hold some promise. In particular, self-help interventions that are rooted in evidence-based concepts may be helpful as an add-on to standard interventions and as (initial) therapeutic strategies for those who are presently reluctant to participate in face-to-face treatment.
The current review identifies self-help, which is based on evidence-based concepts, as a promising clinical tool for the treatment of OCD. The current literature suggests that self-help can be a facilitator and aid to standard face-to-face interventions, rather than a rival.
尽管对强迫症(OCD)的认识和治疗有所进展,但对于大多数患者来说,即使经过治疗干预,一些症状仍会持续存在。还有另一大群体根本不寻求治疗,特别是因为感到羞耻或害怕污名化。OCD 的治疗缺口很大,自助治疗越来越被视为一种针对症状较轻或目前对治疗犹豫不决的个体的低门槛干预形式。我们的综述总结了不断扩大但仍很小的强迫症自助和互联网干预文献,并就如何开展自助(互联网)研究提供了建议。讨论了应对互联网研究中众所周知的方法学问题的策略。
尽管目前综述中考虑的大多数研究都存在固有的方法学限制,而且一些最近的发现也没有得到重复,但自助工具还是有一定希望的。特别是,基于循证概念的自助干预措施可能有助于作为标准干预措施的附加手段,以及作为目前不愿参与面对面治疗的人的初始治疗策略。
本综述确定了基于循证概念的自助治疗是 OCD 治疗的一种有前途的临床工具。目前的文献表明,自助治疗可以促进和辅助标准的面对面干预,而不是与之竞争。