Suppr超能文献

拉丁美洲精神卫生保健提供者对强迫症的误诊

Obsessive-Compulsive Disorder Misdiagnosis among Mental Healthcare Providers in Latin America.

作者信息

Perez Mayra I, Limon Danica L, Candelari Abigail E, Cepeda Sandra L, Ramirez Ana C, Guzick Andrew G, Kook Minjee, La Buissonniere Ariza Valerie, Schneider Sophie C, Goodman Wayne K, Storch Eric A

机构信息

Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine.

Department of Psychology, Brigham Young University.

出版信息

J Obsessive Compuls Relat Disord. 2022 Jan;32. doi: 10.1016/j.jocrd.2021.100693. Epub 2021 Nov 1.

Abstract

Mental healthcare professionals often have limited awareness of different obsessive-compulsive disorder (OCD) symptom presentations, which may contribute to years between OCD symptom onset and treatment initiation. While research has identified high rates of OCD misdiagnosis among clinicians from the United States and Canada, research on OCD symptom awareness among healthcare providers in Latin American (LATAM) regions is limited. In this study, LATAM mental healthcare providers ( = 83) provided diagnostic impressions based on five OCD vignettes: three with symptoms centered on taboo thoughts (sexual, harming others, and religion/scrupulosity) and two about contamination or symmetry obsessions. Rates of incorrect (non-OCD) diagnoses were significantly higher for the taboo thoughts vignettes (sexual, 52.7%; harm/aggression, 42.0%; and religious, 34.7%) vs. contamination obsessions (11.0%) and symmetry obsessions (6.9%). The OCD vignette depicting sexual obsessions was often attributed to a paraphilic disorder (36.5%). Bachelor's level clinicians had significantly lower odds of accurately identifying all three vignettes related to taboo thoughts compared to respondents with a graduate degree. Accurate identification of the three taboo vignettes was also associated with first-line psychological treatment recommendations (i.e., cognitive-behavioral therapy) even when controlling for respondents' theoretical orientation. Exposure was rarely mentioned when clinicians were prompted to provide treatment recommendations for each vignette (8-9% of the time for symmetry and contamination vignettes, 5-7% for taboo though vignettes). Like clinicians in the United States and Canada, mental health professionals in LATAM may misidentify OCD symptom presentations, particularly sexual obsessions, highlighting a need for education and training.

摘要

精神卫生保健专业人员对不同的强迫症(OCD)症状表现往往认识有限,这可能导致从强迫症症状出现到开始治疗之间间隔数年。虽然研究发现美国和加拿大的临床医生对强迫症的误诊率很高,但关于拉丁美洲(LATAM)地区医疗服务提供者对强迫症症状的认识的研究却很有限。在这项研究中,拉丁美洲的精神卫生保健专业人员(n = 83)根据五个强迫症案例提供诊断意见:三个案例的症状集中在禁忌思想(性、伤害他人和宗教/谨小慎微)上,另外两个案例是关于污染或对称强迫观念。与污染强迫观念(11.0%)和对称强迫观念(6.9%)相比,禁忌思想案例的错误(非强迫症)诊断率显著更高(性方面为52.7%;伤害/攻击方面为42.0%;宗教方面为34.7%)。描述性强迫观念的强迫症案例常常被归因于性偏好障碍(36.5%)。与拥有研究生学位的受访者相比,本科水平的临床医生准确识别所有三个与禁忌思想相关案例的几率显著更低。即使在控制受访者的理论取向的情况下,准确识别这三个禁忌案例也与一线心理治疗建议(即认知行为疗法)相关。当临床医生被要求为每个案例提供治疗建议时,暴露疗法很少被提及(对称和污染案例为8 - 9%的时间,禁忌思想案例为5 - 7%的时间)。与美国和加拿大的临床医生一样,拉丁美洲的心理健康专业人员可能会错误识别强迫症症状表现,尤其是性强迫观念,这凸显了教育和培训的必要性。

相似文献

4
OCD Taboo Thoughts and Stigmatizing Attitudes in Clinicians.临床医生对强迫症的禁忌思维和污名化态度。
Community Ment Health J. 2017 Apr;53(3):275-280. doi: 10.1007/s10597-016-0055-x. Epub 2016 Nov 2.
5
6
The characteristics of unacceptable/taboo thoughts in obsessive-compulsive disorder.强迫症中不可接受/禁忌思维的特征。
Compr Psychiatry. 2013 Oct;54(7):750-7. doi: 10.1016/j.comppsych.2013.02.005. Epub 2013 Apr 12.
9
10

引用本文的文献

6
Diagnostic error in mental health: a review.精神健康诊断错误:综述。
BMJ Qual Saf. 2024 Sep 19;33(10):663-672. doi: 10.1136/bmjqs-2023-016996.
7
Variations in obsessive compulsive disorder symptomatology across cultural dimensions.跨文化维度的强迫症症状学差异。
Front Psychiatry. 2024 Jan 23;15:1329748. doi: 10.3389/fpsyt.2024.1329748. eCollection 2024.

本文引用的文献

2
Course and outcome of obsessive-compulsive disorder.强迫症的病程及转归
Indian J Psychiatry. 2019 Jan;61(Suppl 1):S43-S50. doi: 10.4103/psychiatry.IndianJPsychiatry_521_18.
3
Influence of Culture in Obsessive-compulsive Disorder and Its Treatment.文化在强迫症及其治疗中的影响
Curr Psychiatry Rev. 2017 Dec;13(4):285-292. doi: 10.2174/2211556007666180115105935.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验