Arikawa Ayako, Mito Hironori, Motoyama Mikuni, Yamanishi Kyosuke, Hayashida Kazuhisa, Maebayashi Kensei, Matsunaga Hisato
Seishin Shinkeigaku Zasshi. 2015;117(11):893-901.
Obsessive-compulsive and related disorders (OCRDs) have been introduced in a revision to DSM-5 as a novel category that is distinct from other anxiety disorders in DSM-IV. OCRDs consist of 5 primary disorders: obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder (HD), skin picking disorder (SPD), and hair pulling disorder (HPD), which share core clinical features such as preoccupation or recurrent thoughts and/or repetitive behaviors. Repetitive behaviors in BDD and HD can be differentially characterized by the presence of cognitive components associated with preceding anxiety from those in SPD or HPD, which are only observed as motoric components that regulate emotions or alleviate tension. Thus, the validity of the OCRD category and specific interrelationships between each OCRD remain uncertain. In the present study, therefore, we presented a case of multiple comorbidities of OCRDs in order to discuss the nature of the OCRD category. Our patient was a 20-year-old female university student. At the age of 11 years old, she started picking at acne on her face. The psychopathological, and treatment features observed in this case indicated possible interrelationships among OCRDs, especially between cognitive and motoric OCRDs, which supported the clinical utility and continuous nature of this category.
强迫及相关障碍（OCRDs）在《精神疾病诊断与统计手册》第五版（DSM-5）的修订版中被引入，作为一个与DSM-IV中的其他焦虑症不同的新类别。OCRDs包括5种主要疾病：强迫症（OCD）、躯体变形障碍（BDD）、囤积障碍（HD）、皮肤搔抓障碍（SPD）和拔毛障碍（HPD），它们具有共同的核心临床特征，如专注或反复出现的想法和/或重复行为。BDD和HD中的重复行为与SPD或HPD中的重复行为在特征上可能有所不同，前者存在与先前焦虑相关的认知成分，而后者仅表现为调节情绪或缓解紧张的运动成分。因此，OCRD类别的有效性以及各OCRD之间的具体相互关系仍不明确。因此，在本研究中，我们报告了一例OCRDs多重共病的病例，以探讨OCRD类别的性质。我们的患者是一名20岁的女大学生。11岁时，她开始抠脸上的粉刺。该病例中观察到的精神病理学和治疗特征表明OCRDs之间可能存在相互关系，尤其是认知性和运动性OCRDs之间的关系，这支持了该类别的临床实用性和连续性。
