Jassi Amita, Shahriyarmolki Khodayar, Taylor Tracey, Peile Lauren, Challacombe Fiona, Clark Bruce, Veale David
National Specialist Clinic for Young People with OCD, BDD and Related Disorders, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK.
Centre for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK.
Cogn Behav Therap. 2020 Jul 14;13:e27. doi: 10.1017/S1754470X20000318. eCollection 2020.
People with obsessive compulsive disorder (OCD) are likely to be more susceptible to the mental health impact of COVID-19. This paper shares the perspectives of expert clinicians working with OCD considering how to identify OCD in the context of COVID-19, changes in the presentation, and importantly what to consider when undertaking cognitive behaviour therapy (CBT) for OCD in the current climate. The expert consensus is that although the presentation of OCD and treatment may have become more difficult, CBT should still continue remotely unless there are specific reasons for it not to, e.g. increase in risk, no access to computer, or exposure tasks or behavioural experiments cannot be undertaken. The authors highlight some of the considerations to take in CBT in light of our current understanding of COVID-19, including therapists and clients taking calculated risks when developing behavioural experiments and exposure tasks, considering viral loading and vulnerability factors. Special considerations for young people and perinatal women are discussed, as well as foreseeing what life may be like for those with OCD after the pandemic is over.
(1)To learn how to identify OCD in the context of COVID-19 and consider the differences between following government guidelines and OCD.(2)To consider the presentation of OCD in context of COVID-19, with regard to cognitive and behavioural processes.(3)Review factors to be considered when embarking on CBT for OCD during the pandemic.(4)Considerations in CBT for OCD, including weighing up costs and benefits of behavioural experiments or exposure tasks in light of our current understanding of the risks associated with COVID-19.
患有强迫症(OCD)的人可能更容易受到新冠病毒病(COVID-19)对心理健康的影响。本文分享了从事强迫症治疗的专家临床医生的观点,内容涉及如何在COVID-19背景下识别强迫症、症状表现的变化,以及重要的是在当前环境下对强迫症进行认知行为疗法(CBT)时应考虑的因素。专家共识是,尽管强迫症的症状表现和治疗可能变得更加困难,但除非有特殊原因(例如风险增加、无法使用电脑、无法进行暴露任务或行为实验),CBT仍应继续以远程方式进行。作者根据我们目前对COVID-19的了解,强调了在CBT中需要考虑的一些因素,包括治疗师和患者在制定行为实验和暴露任务时要权衡风险,考虑病毒载量和易感性因素。文中还讨论了对年轻人和围产期妇女的特殊考虑,以及预测大流行结束后强迫症患者的生活可能会是什么样。
(1)了解如何在COVID-19背景下识别强迫症,并考虑遵循政府指导方针与强迫症之间的差异。(2)在COVID-19背景下,从认知和行为过程方面考虑强迫症的症状表现。(3)回顾在大流行期间对强迫症进行CBT时需要考虑的因素。(4)强迫症CBT中的注意事项,包括根据我们目前对与COVID-19相关风险的了解,权衡行为实验或暴露任务的成本和收益。