Lombardi Anthony, Rodriguez Carolyn
Stanford University School of Medicine, Palo Alto, California.
J Cogn Psychother. 2019 Aug 1;33(3):185-195. doi: 10.1891/0889-8391.33.3.185.
Obsessive-compulsive disorder (OCD), characterized by repetitive thoughts (obsessions) and behaviors (compulsions), is a leading cause of health-related disability in the world. Various kinds of obsessions and compulsions exist and tend to co-occur in dimensions (e.g., doubting/checking, symmetry/ordering, contamination/cleaning). Cognitive-behavioral therapy (CBT) consisting of exposure and response (ritual) prevention (ERP) is arguably the safest and most efficacious treatment for OCD. ERP involves exposing OCD patients to stimuli that provoke obsessions while coaching them to not ritualize. There is increasing evidence to suggest that the specific symptom dimensions of OCD have unique correlates and different responsiveness to ERP. Although many patients respond to ERP, only a subset achieve minimal symptoms. Given the challenges that may arise in ERP treatment of specific OCD dimensions, there has been increasing interest in examining OCD with relationship-related themes that focus on the romantic relationship or partner. In this case report, we present a case of an adult with OCD containing relationship themes and highlight ERP adaptations we utilized to improve his treatment course.
强迫症（OCD）以反复出现的想法（强迫观念）和行为（强迫行为）为特征，是全球与健康相关残疾的主要原因。存在各种各样的强迫观念和强迫行为，并且往往在不同维度上同时出现（例如，怀疑/检查、对称/排序、污染/清洁）。由暴露与反应（仪式）预防（ERP）组成的认知行为疗法（CBT）可以说是治疗强迫症最安全、最有效的方法。ERP包括让强迫症患者接触引发强迫观念的刺激，同时指导他们不要进行仪式化行为。越来越多的证据表明，强迫症的特定症状维度具有独特的关联，并且对ERP有不同的反应性。尽管许多患者对ERP有反应，但只有一部分患者症状减轻到最低程度。鉴于在针对特定强迫症维度的ERP治疗中可能出现的挑战，人们越来越关注对以浪漫关系或伴侣为重点的与关系相关主题的强迫症的研究。在本病例报告中，我们介绍了一例患有包含关系主题强迫症的成年人病例，并强调了我们为改善其治疗过程所采用的ERP调整方法。
