Mavrogiorgou P, Siebers F, Kienast T, Juckel G
Klinik für Psychiatrie Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum der Ruhr Universität Bochum, Alexandrinenstr. 1, 44791, Bochum, Deutschland.
Nervenarzt. 2015 Sep;86(9):1130-9. doi: 10.1007/s00115-015-4298-5.
Obsessive-compulsive disorder (OCD) is a chronic and debilitating disorder that is relatively common and is associated with a wide range of functional impairments. This is partly associated with delayed help-seeking behavior of OCD patients, which shows a lag of up to 10 years after onset of the obsessive-compulsive symptoms to the first attempt at seeking professional treatment. The reasons for the delay in initial help-seeking behavior by OCD patients are manifold but still not clear. Early detection and early treatment might, however, have beneficial effects on the treatment-seeking behavior.
The aim of the study was to examine the help-seeking behavior and the pathways to care of patients with OCD using a modified version of the structured pathways to care questionnaire initially designed for research into schizophrenia.
For the 40 outpatients with OCD who completed the interview retrospectively, the latent period between symptom onset and first seeking professional contact was on average 6.5 years, while the median delay to a third attempt at seeking treatment was nearly 15 years. Although the majority of participants consulted a professional neurological and psychotherapeutic practice even at the first attempt and 90% complained of specific OCD symptoms, only 20% received the standard treatment consisting of cognitive behavioral therapy and medication with a selective serotonin reuptake inhibitor (SSRI). The most common reason for delaying seeking treatment was that the patient was not convinced of having a mental illness such as OCD and of the necessity for treatment. Even so, approximately 40% of the participants reported fear of stigmatization and discrimination as a major reason for the delay in the first attempt at seeking help.
Psychoeducation and broad utilization of evidence-based treatment still appears necessary and can contribute to improvement in the help-seeking behavior of OCD patients.
强迫症（OCD）是一种慢性且使人衰弱的疾病，相对常见，与广泛的功能损害相关。这部分与强迫症患者寻求帮助行为的延迟有关，该延迟在强迫症状发作至首次尝试寻求专业治疗之间长达10年。强迫症患者首次寻求帮助行为延迟的原因多种多样，但仍不清楚。然而，早期发现和早期治疗可能对寻求治疗行为产生有益影响。
本研究的目的是使用最初为精神分裂症研究设计的结构化就医途径问卷的修改版，来检查强迫症患者的就医途径和寻求护理的途径。
对于40名回顾性完成访谈的强迫症门诊患者，症状发作与首次寻求专业接触之间的潜伏期平均为6.5年，而第三次尝试寻求治疗的中位延迟时间接近15年。尽管大多数参与者即使在首次尝试时也咨询了专业的神经科和心理治疗机构，且90%的人抱怨有特定的强迫症症状，但只有20%的人接受了由认知行为疗法和选择性5-羟色胺再摄取抑制剂（SSRI）药物组成的标准治疗。延迟寻求治疗的最常见原因是患者不相信自己患有强迫症等精神疾病以及不相信治疗的必要性。即便如此，约40%的参与者报告称害怕被污名化和歧视是首次寻求帮助延迟的主要原因。
心理教育和循证治疗的广泛应用似乎仍然必要，并且有助于改善强迫症患者的就医行为。
