治疗一例首发精神病以揭示未确诊的强迫症：病例报告
Treating a Case of First-Episode Psychosis to Uncover Undiagnosed Obsessive Compulsive Disorder: A Case Report.
作者信息
Wazir Larayeb, Astacio Dario A, Lind Suzanne M
机构信息
Psychiatry and Behavioral Sciences, Army Medical College, National University of Medical Sciences, Rawalpindi, PAK.
Psychiatry, St. Mary's General Hospital, Passiac, USA.
出版信息
Cureus. 2023 Jun 30;15(6):e41184. doi: 10.7759/cureus.41184. eCollection 2023 Jun.
Abstract
Obsessive-compulsive disorder (OCD) is a chronic psychiatric condition characterized by the presence of obsessions, compulsions, or both. Historically OCD was associated with good insight. However, there are more categories to the degrees of insight in OCD patients, namely good, fair, poor, absent, or delusional beliefs. It is also important to note that insight can fluctuate circumstantially. We describe a rare case of first-episode psychosis of undetermined cause presenting with suicidal ideation. After continued treatment, it was discovered to be previously undiagnosed OCD with poor insight.
摘要
强迫症（OCD）是一种慢性精神疾病，其特征是存在强迫观念、强迫行为或两者皆有。从历史上看，强迫症与良好的自知力有关。然而，强迫症患者的自知力程度有更多类别，即良好、尚可、差、缺失或妄想信念。还需要注意的是，自知力可能会因情况而波动。我们描述了一例病因不明的首发精神病性障碍病例，该患者伴有自杀观念。经过持续治疗后，发现其为先前未被诊断出的自知力差的强迫症。
相似文献
1
Treating a Case of First-Episode Psychosis to Uncover Undiagnosed Obsessive Compulsive Disorder: A Case Report.治疗一例首发精神病以揭示未确诊的强迫症：病例报告
Cureus. 2023 Jun 30;15(6):e41184. doi: 10.7759/cureus.41184. eCollection 2023 Jun.
2
Psychiatric Comorbidities and the Risk of Suicide in Obsessive-Compulsive and Body Dysmorphic Disorder.强迫症和躯体变形障碍中的精神共病与自杀风险
Cureus. 2020 Aug 17;12(8):e9805. doi: 10.7759/cureus.9805.
3
Obsessive-Compulsive Disorder with Suicide Obsessions in a First Responder without Previous Diagnosis of OCD or History of Suicide Attempts.一名急救人员患有自杀强迫观念的强迫症，此前未被诊断为强迫症，也没有自杀未遂史。
Case Rep Psychiatry. 2017;2017:4808275. doi: 10.1155/2017/4808275. Epub 2017 Oct 2.
4
Differential diagnosis of obsessive-compulsive symptoms from delusions in schizophrenia: A phenomenological approach.精神分裂症中强迫症状与妄想的鉴别诊断：一种现象学方法。
World J Psychiatry. 2013 Sep 22;3(3):50-6. doi: 10.5498/wjp.v3.i3.50.
5
A hypothesis on Cotard's syndrome as an evolution of obsessive-compulsive disorder.关于科塔尔综合征是强迫症演变的假说。
Int Rev Psychiatry. 2021 Feb-Mar;33(1-2):23-28. doi: 10.1080/09540261.2020.1810425. Epub 2020 Oct 5.
6
Phenomenology of OCD: lessons from a large multicenter study and implications for ICD-11.强迫症的现象学：来自一项大型多中心研究的经验教训及对《国际疾病分类第11版》的启示
J Psychiatr Res. 2014 Oct;57:141-8. doi: 10.1016/j.jpsychires.2014.06.010. Epub 2014 Jun 26.
7
Prevalence and correlates of current suicide risk in an international sample of OCD adults: A report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) network and Obsessive Compulsive and Related Disorders Network (OCRN) of the European College of Neuropsychopharmacology.在一个国际 OCD 成人样本中，当前自杀风险的流行率及其相关因素：来自国际强迫症谱系障碍学院（ICOCS）网络和欧洲神经精神药理学学院强迫症及相关障碍网络（OCRN）的报告。
J Psychiatr Res. 2021 Aug;140:357-363. doi: 10.1016/j.jpsychires.2021.05.054. Epub 2021 May 27.
8
Obsessions and Compulsions in Postpartum Women Without Obsessive Compulsive Disorder.无强迫症的产后女性的强迫观念与强迫行为
J Womens Health (Larchmt). 2015 Oct;24(10):825-30. doi: 10.1089/jwh.2014.5063. Epub 2015 Jun 29.
9
A comparison of insight in body dysmorphic disorder and obsessive-compulsive disorder.躯体变形障碍与强迫症的洞察力比较。
J Psychiatr Res. 2012 Oct;46(10):1293-9. doi: 10.1016/j.jpsychires.2012.05.016. Epub 2012 Jul 21.
10
Obsessive-Compulsive Symptoms in Obsessive-Compulsive Disorder and in Generalized Anxiety Disorder: Occurrence and Correlations.强迫症和广泛性焦虑症中的强迫症状：发生率和相关性。
J Psychiatr Pract. 2020 Mar;26(2):101-119. doi: 10.1097/PRA.0000000000000451.
本文引用的文献
1
The Relationships Between Obsessive-Compulsive Disorder and Psychosis: An Unresolved Issue.强迫症与精神病之间的关系：一个未解决的问题。
Clin Neuropsychiatry. 2020 Jun;17(3):149-157. doi: 10.36131/cnfioritieditore20200302.
2
Obsessive-Compulsive Symptoms in Schizophrenia: an Up-To-Date Review of Literature.精神分裂症中的强迫症状：文献的最新综述。
Curr Psychiatry Rep. 2019 Jul 1;21(8):64. doi: 10.1007/s11920-019-1051-y.
3
Obsessive-compulsive symptoms in schizophrenia: a review.精神分裂症中的强迫症状：综述
Acta Neuropsychiatr. 2019 Apr;31(2):63-73. doi: 10.1017/neu.2018.27. Epub 2018 Dec 18.
4
The role of metacognition and obsessive-compulsive symptoms in psychosis: an analogue study.元认知与强迫症状在精神病中的作用：一项模拟研究。
BMC Psychiatry. 2017 Jun 29;17(1):233. doi: 10.1186/s12888-017-1392-1.
5
Psychosis or Obsessions? Clozapine Associated with Worsening Obsessive-Compulsive Symptoms.精神病还是强迫观念？氯氮平与强迫症状恶化有关。
Case Rep Psychiatry. 2016;2016:2180748. doi: 10.1155/2016/2180748. Epub 2016 May 30.
6
Prevalence and clinical characteristics of patients with obsessive-compulsive disorder in first-episode psychosis.首发精神病患者中强迫症的患病率及临床特征。
BMC Psychiatry. 2013 May 30;13:156. doi: 10.1186/1471-244X-13-156.
7
A longitudinal study of obsessive-compulsive disorder in individuals at ultra-high risk for psychosis.精神分裂症超高危人群中强迫症的纵向研究。
J Psychiatr Res. 2011 Sep;45(9):1140-5. doi: 10.1016/j.jpsychires.2011.03.005. Epub 2011 Mar 26.
8
Obsessive-Compulsive Disorder (OCD) is still an unrecognised disorder: a study on the recognition of OCD in psychiatric outpatients.强迫症（OCD）仍然未被识别：一项关于精神科门诊患者对 OCD 识别的研究。
Eur Psychiatry. 2010 Nov;25(7):374-7. doi: 10.1016/j.eurpsy.2009.12.003.
9
Metacognitive beliefs in obsessive-compulsive patients: a comparison with healthy and schizophrenia participants.强迫症患者的元认知信念：与健康参与者和精神分裂症患者的比较。
Cogn Neuropsychiatry. 2010 Nov;15(6):531-48. doi: 10.1080/13546801003783508. Epub 2010 May 4.
10
Obsessive-compulsive disorder with poor insight: a three-year prospective study.伴有洞察力差的强迫症：一项为期三年的前瞻性研究。
Prog Neuropsychopharmacol Biol Psychiatry. 2010 Mar 17;34(2):323-30. doi: 10.1016/j.pnpbp.2009.12.007. Epub 2009 Dec 16.
Zotero 插件