Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
Neuropsychiatr Dis Treat. 2011;7:485-94. doi: 10.2147/NDT.S13205. Epub 2011 Aug 23.
Obsessive-compulsive disorder (OCD) is a chronic anxiety disorder. While medication and psychotherapy advances have been very helpful to patients, many patients do not respond adequately to initial trials of serotonergic medication or cognitive-behavioral therapy (CBT) and require multiple treatment trials or combination therapies. Comorbidity may also influence treatment response. The role of streptococcal infections in pediatric OCD has become an area of intense scrutiny and controversy. In this article, current treatment methods for OCD will be reviewed, with special attention to strategies for treating OCD in children and in patients with comorbid tic disorders. Alternative psychotherapy strategies for patients who are highly anxious about starting CBT, such as cognitive therapy or augmentation with D-cycloserine, will be reviewed. Newer issues regarding use of antibiotics, neuroleptics, and glutamate modulators in OCD treatment will also be explored.
强迫症（OCD）是一种慢性焦虑症。虽然药物治疗和心理治疗的进步对患者非常有帮助，但许多患者对初始的血清素能药物或认知行为疗法（CBT）治疗反应不足，需要多次治疗试验或联合治疗。共病也可能影响治疗反应。链球菌感染在儿童强迫症中的作用已成为一个备受关注和争议的领域。本文将回顾强迫症的当前治疗方法，特别关注治疗儿童强迫症和伴有抽动障碍的患者的策略。对于那些对开始接受 CBT 非常焦虑的患者，如认知疗法或用 D-环丝氨酸增效，将审查替代心理治疗策略。本文还将探讨强迫症治疗中抗生素、神经阻滞剂和谷氨酸调节剂使用的一些新问题。
