Krzyszkowiak Waldemar, Kuleta-Krzyszkowiak Małgorzata, Krzanowska Eliza
Zespół Lekarzy i Psychologów In Altum w Warszawie.
Uniwersytet Jagielloński, Wydział Zarządzania i Komunikacji Społecznej, Instytut Psychologii Stosowanej, Zakład Interwencji Kryzysowej i PsychoterapiI.
Psychiatr Pol. 2019 Aug 31;53(4):825-843. doi: 10.12740/PP/105130.
The purpose of this article is to present an overview of current knowledge on the treatment of obsessive-compulsive and obsessive-compulsive-related disorders (OCRD - according to DSM-5). The article presents commonly used pharmacological treatments and psychotherapy, as well as surgical and other forms of treatment. According to the analyses that have been made, the variety of responses to the pharmacological treatment of obsessive-compulsive disorders (OCD) depending on the kinds of symptoms is not relevant enough to justify these other forms of treatment. Instead, the choice of medication should be made based on other factors, such as the severity of symptoms and the level of insight into the illness or the symptoms of other disorders co-occurring with the obsessions. These factors are also significant in psychotherapy, but in this case, the dependency between the types of obsessions and compulsions and the therapeutic approach has greater importance. Generally speaking, in OCRD treatment, atendency to use other forms of treatment can be observed for disorders based mainly on the mechanism of compulsivity or impulsivity. Hopes for a more effective treatment are related to the types of pharmacological treatment and modifications of psychotherapeutic methods based on the development happening in the cognitive behavioural approach.
本文旨在概述目前关于强迫症及相关障碍（根据《精神疾病诊断与统计手册》第五版，即OCRD）治疗的知识。文章介绍了常用的药物治疗、心理治疗，以及手术和其他治疗形式。根据已进行的分析，强迫症药物治疗因症状类型而异的多种反应，其关联性不足以证明这些其他治疗形式的合理性。相反，药物选择应基于其他因素，如症状的严重程度、对疾病的洞察水平或与强迫观念同时出现的其他障碍的症状。这些因素在心理治疗中也很重要，但在这种情况下，强迫观念和强迫行为的类型与治疗方法之间的相关性更为重要。一般来说，在OCRD治疗中，对于主要基于强迫或冲动机制的障碍，可以观察到使用其他治疗形式的趋势。更有效治疗的希望与药物治疗的类型以及基于认知行为方法发展的心理治疗方法的改进有关。
