Prasko Jan, Hruby Radovan, Ociskova Marie, Holubova Michaela, Latalova Klara, Marackova Marketa, Grambal Ales, Sigmundova Zuzana, Kasalova Petra, Vyskocilová Jana
Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic.
Psychiatric Outpatient Department, Martin, Slovakia.
Neuro Endocrinol Lett. 2016 Oct;37(5):373-382.
Obsessive compulsive disorder (OCD) is a disabling mental disorder with the chronic and difficult course. The disorder is accompanied by numerous limitations in personal and interpersonal functioning. OCD decreases the quality of life and the chance to maintain relationships and professional status. The patients with OCD often experience a severe disabling course of the disorder. Even the individuals, who follow treatment advice, are often still highly symptomatic. In the last decade, the concept of the needs has been assessed as an extent of the traditional outcome evaluation in order to focus on the identification of the specific needs of the patients and their relatives, improve the patients´ overall mental condition and quality of life, and also to increase the treatment effectiveness of the mental disorders. The objective of the article was to review the current literature about unmet needs of the OCD patients and their caregivers.
A computerized search of the literature published between January 2000 and June 2016 was conducted in MEDLINE, and additional papers were extracted using keywords "obsessive compulsive disorder","needs", "pharmacotherapy", "CBT", and "family" in various combinations. Primary selection selected the total of 449 articles. According to the established criteria, 168 articles were chosen. After a detailed examination of the full texts, 53 articles remained. Secondary articles from the reference lists of primarily selected papers were read and evaluated for the eligibility and added to the final list of the articles (n = 107).
The needs of the OCD patients might differ at various stages and severity of the disorder. Four sets of the needs were identified: the needs connected with the symptoms, the treatment, the quality of life, and the family. The patients suffering from OCD often experience many limitations in the fulfillment of their fundamental human needs such as disturbed patients´ functioning in the common life, family, at work, in the ability to realize their goals, skills, potential, capacity to follow prescribed treatment, take medication, cooperate in addressing the root causes of their problems, reduce obsessive thoughts and compulsive behavior, as well as their willingness to realize exposures with the desire to resolve the situation.
Monitoring the patients´ needs may be relevant for the treatment of the individuals suffering from OCD. A bigger focus on the patients´ needs could be beneficial and should be targeted in the treatment.
强迫症（OCD）是一种致残性精神障碍，病程慢性且艰难。该疾病伴有个人及人际功能方面的诸多限制。强迫症会降低生活质量，减少维持人际关系和职业地位的机会。强迫症患者常常经历严重的致残病程。即便遵循治疗建议的患者，往往仍有高度的症状表现。在过去十年中，需求的概念已被评估为传统结局评估的一个范畴，以便专注于识别患者及其亲属的特定需求，改善患者的整体心理状况和生活质量，并提高精神障碍的治疗效果。本文的目的是综述关于强迫症患者及其照料者未满足需求的当前文献。
在MEDLINE中对2000年1月至2016年6月发表的文献进行计算机检索，并使用“强迫症”“需求”“药物治疗”“认知行为疗法”和“家庭”等关键词以各种组合方式提取其他论文。初步筛选共选出449篇文章。根据既定标准，选取了168篇文章。在对全文进行详细审查后，剩下53篇文章。阅读并评估了主要入选论文参考文献列表中的二级文章的合格性，并将其添加到文章最终列表中（n = 107）。
强迫症患者的需求可能在疾病的不同阶段和严重程度有所不同。确定了四组需求：与症状、治疗、生活质量和家庭相关的需求。患有强迫症的患者在满足其基本人类需求方面常常经历许多限制，例如患者在日常生活、家庭、工作中的功能紊乱，实现目标的能力、技能、潜力，遵循规定治疗、服药、配合解决问题根源的能力下降，减少强迫观念和强迫行为的能力，以及他们面对暴露以解决问题的意愿。
监测患者需求可能与强迫症患者的治疗相关。更多地关注患者需求可能有益，且应在治疗中加以针对性处理。
