Brady Charles F
From the Lindner Center of HOPE and Lindner Center Professional Associates, Mason, Ohio, and the Department of Psychiatry, University of Cincinnati and University of Cincinnati Physicians, Cincinnati, Ohio.
J Clin Psychiatry. 2014 Mar;75(3):e07. doi: 10.4088/JCP.13023tx2c.
Some of the most common complicating factors for clinicians treating a person with obsessive-compulsive disorder include suicidal obsessions, dangerous compulsions, overvalued ideation, and low motivation. When a patient reports suicidal thoughts, clinicians must assess whether these thoughts are ego-syntonic or ego-dystonic because patients with ego-dystonic suicidal obsessions have less risk of imminent harm. For individuals whose compulsions are dangerous, clinicians must determine the best type of treatment facility to reduce the risk of harm. Patients with overvalued ideation may require unique interviewing approaches and the support of family members. Finally, clinicians should assess for health problems that can cause low energy and fatigue and consider motivational interviewing and additional therapies for patients who have low motivation to continue treatment.
临床医生在治疗强迫症患者时，一些最常见的复杂因素包括自杀观念、危险的强迫行为、超价观念和动机不足。当患者报告有自杀想法时，临床医生必须评估这些想法是自我协调的还是自我不协调的，因为自我不协调的自杀观念患者面临迫在眉睫伤害的风险较小。对于那些强迫行为危险的个体，临床医生必须确定最佳的治疗机构类型，以降低伤害风险。有超价观念的患者可能需要独特的访谈方法和家庭成员的支持。最后，临床医生应该评估可能导致精力不足和疲劳的健康问题，并考虑对缺乏继续治疗动机的患者进行动机访谈和其他治疗。
