Kertesz Adrienn, Kiss-Leizer Marton, Szalma Istvan, Vizin Gabriella
Eötvös Loránd Tudományegyetem, Pszichológiai Doktori Iskola, Budapest, Hungary.
Neuropsychopharmacol Hung. 2020 Sep;22(3):129-140.
According to the currently available research data obsessive-compulsive disorder (OCD)is a disorder of multifactorial etiology, the causes of which include biological, genetic and environmental-social factors alike. Based on an etiology of that kind, it is justifiable to conduct a developmental psychopathological review of OCD, which may lead, through an exploration of the different factors involved, to a deeper understanding of the disorder's overall nature and specific characteristics, as well as to the development of the most efficient therapies possible. The main objective of the present comprehensive study is the developmental psychopathological analysis of the OCD, including the review of the evolutionary approaches and genetic and environmental factors, as well as an exploration of OCD's age-specific forms of manifestation, based on the recent research results and analyses available in the professional literature. According to our present knowledge, the genetic linkage of early-onset OCD is greater than that of the late-onset variant, as the onset of the syndrome can be attributed to genetic factors to the extent of 40-60%, coupled with the contribution of environmental factors like perinatal disorders, reproductive cycle, childhood infections, familial circumstances, age of the parents and traumatic life events. Evolutionary theories address OCD from a functional perspective. They strive to attribute it primarily to individual or group selection theories that a quite heterogeneous OCD syndrome, which is therapeutically difficult to change, remains to present itself with close to identical, invariably high prevalence in all cultures despite the difficulties. Obsessive-compulsive disorder is present in all ages, and it is often difficult to determine whether we are faced with a healthy or a pathological behavior, as certain obsessive phenomena may appear as part of normal development. The analysis of OCD's etiology, a better understanding of the respective function of specific symptoms, a thorough exploration of age-specific variants of the disorder, i.e. a developmental psychopathological analysis of OCD, is of key importance from diagnostic, therapeutic and vocational rehabilitation aspects alike.
根据目前可得的研究数据，强迫症（OCD）是一种病因多因素的疾病，其病因包括生物、遗传和环境 - 社会因素。基于这种病因，对强迫症进行发展性心理病理学回顾是合理的，通过探索其中涉及的不同因素，这可能会加深对该疾病整体性质和具体特征的理解，以及开发出尽可能有效的治疗方法。本综合研究的主要目的是对强迫症进行发展性心理病理学分析，包括回顾进化方法以及遗传和环境因素，同时根据专业文献中现有的最新研究结果和分析，探索强迫症在特定年龄阶段的表现形式。根据我们目前的知识，早发性强迫症的遗传关联性大于晚发性变体，因为该综合征发病的40 - 60%可归因于遗传因素，同时还有诸如围产期疾病、生殖周期、儿童期感染、家庭环境、父母年龄和创伤性生活事件等环境因素的作用。进化理论从功能角度研究强迫症。它们主要试图将其归因于个体或群体选择理论，即尽管存在困难，但一种相当异质性的、治疗上难以改变的强迫症综合征在所有文化中仍以几乎相同的、始终很高的患病率出现。强迫症存在于所有年龄段，而且往往很难确定我们面对的是健康行为还是病理行为，因为某些强迫现象可能作为正常发育的一部分出现。对强迫症病因的分析、对特定症状各自功能的更好理解、对该疾病特定年龄变体的深入探索，即对强迫症进行发展性心理病理学分析，从诊断、治疗和职业康复等方面来看都至关重要。
