Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.
Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.
PLoS One. 2019 Mar 20;14(3):e0213495. doi: 10.1371/journal.pone.0213495. eCollection 2019.
Obsessive-compulsive disorder (OCD) is a serious mental health problem that causes significant impairment and reduced quality of life. Though some substantially benefit from psychological therapies, a substantial proportion of people with OCD disengage from treatment or fail to benefit. Theoretical models such as the Common-Sense Model posit that our management of physical illness depends on our perceptions about the condition. Identifying how people with OCD perceive their condition could lead to important insight that would improve treatment of OCD.
To identify and characterise the illness perceptions of people with OCD.
Transcribed semi-structured interviews exploring the illness perceptions of 16 people with OCD were analysed using thematic analysis.
In some cases, identification of symptoms was hindered by a failure to interpret experiences as 'symptoms'. Instead, these individuals interpreted symptoms as a personality quirk, or as evidence that they had become deviant. Perceptions of the condition as 'part' of the self contributed to views of OCD as permanent. Individuals were concerned about the impact of OCD on friends and family and attempted to minimise its consequences, for example by concealing symptoms from their children, who they feared could acquire OCD.
Applying a theoretical model of physical health understanding to OCD yielded novel insights, with important implications for support and treatment. To enable early help-seeking and rapid diagnosis, public and professional knowledge about OCD should be extended beyond 'washing and checking' to the less widely known OCD-subtypes, such as fear of causing harm. It may be important to identify and challenge views of OCD as permanent early in the course of treatment to maximise engagement. Management of OCD should also address the burden of living with OCD in a family context. Further research to test whether these perceptions lead to coping responses and outcomes in OCD is now needed.
强迫症（OCD）是一种严重的心理健康问题，会导致显著的损伤和生活质量下降。尽管有些人从心理治疗中获益匪浅，但仍有相当一部分 OCD 患者会中断治疗或无法从中获益。像“常识模型”这样的理论模型假设，我们对身体疾病的管理取决于我们对疾病的认知。识别 OCD 患者如何看待自己的病情，可能会为改善 OCD 的治疗提供重要的见解。
确定并描述 OCD 患者的疾病认知。
对 16 名 OCD 患者的疾病认知进行了深入访谈，使用主题分析对访谈内容进行了分析。
在某些情况下，由于未能将体验解读为“症状”，因此难以识别症状。相反，这些人将症状解释为个性缺陷，或表明他们已经变得不正常。将疾病视为“自我的一部分”，导致了将 OCD 视为永久性疾病的观点。个体担心 OCD 对朋友和家人的影响，并试图最小化其后果，例如向孩子隐瞒症状，因为他们担心孩子可能会患上 OCD。
将身体健康理解的理论模型应用于 OCD 产生了新的见解，对支持和治疗具有重要意义。为了实现早期寻求帮助和快速诊断，应该扩大公众和专业人士对 OCD 的认识，不仅要了解“洗涤和检查”等常见症状，还要了解不太广为人知的 OCD 亚型，如害怕造成伤害。在治疗早期识别和挑战 OCD 永久性的观点，可能对提高患者的参与度至关重要。OCD 的管理还应解决在家庭环境中生活的负担。现在需要进一步研究来检验这些认知是否会导致 OCD 的应对反应和结果。
