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强迫症症状作为东南亚复杂性创伤后应激障碍的一种独特表现:一例病例报告

Obsessive-compulsive symptoms as a unique presentation of complex posttraumatic stress disorder in Southeast Asia: a case report.

作者信息

Albert Amanda, Chen Yoke Yong

机构信息

Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS), Jalan Datuk Mohd Musa, 94300, Kota Samarahan, Sarawak, Malaysia.

出版信息

J Med Case Rep. 2025 May 31;19(1):261. doi: 10.1186/s13256-025-05323-x.

Abstract

BACKGROUND

Posttraumatic stress disorder is a mental health condition outlining psychological sequelae experienced after encountering a traumatic event. Complex posttraumatic stress disorder, however, is increasingly recognized as being distinct from posttraumatic stress disorder. This is due to an observed variation from what is traditionally defined as a traumatic event, as well as greater heterogeneity in its presentation. Cultural factors may also influence definitions of traumatic events and heterogeneity in presentation.

CASE PRESENTATION

In this case, a 27-year-old Malay male presented with a 9-year history of obsessive-compulsive symptoms of predominantly sexual content. Although initially treated as obsessive-compulsive disorder, persistent negative self-image and features of complex posttraumatic stress disorder surfaced in the course of therapy, stemming from a culturally-related punitive upbringing as well as bullying by peers. He responded markedly well to trauma-based psychotherapy and remains well at time of writing.

CONCLUSION

A diagnosis of complex posttraumatic stress disorder should be considered in the individual who presents with mental health difficulties, particularly if the individual's symptoms are atypical to classical diagnostic criteria or the individual does not respond to conventional treatment. It is important to note the role of cultural background-this may give rise to unique presentations of complex posttraumatic stress disorder, and the triggering events may not be traditionally defined as traumatic. Cultural background may also potentially inform treatment and future prevention strategies for complex posttraumatic stress disorder.

摘要

背景

创伤后应激障碍是一种心理健康状况,描述了在经历创伤性事件后所经历的心理后遗症。然而,复杂性创伤后应激障碍越来越被认为与创伤后应激障碍不同。这是由于观察到其与传统定义的创伤性事件存在差异,以及其表现形式具有更大的异质性。文化因素也可能影响创伤性事件的定义和表现形式的异质性。

病例报告

在本病例中,一名27岁的马来男性有9年主要为性内容的强迫症状病史。尽管最初被诊断为强迫症,但在治疗过程中出现了持续的负面自我形象和复杂性创伤后应激障碍的特征,这源于与文化相关的惩罚性教养方式以及同伴的欺凌。他对基于创伤的心理治疗反应显著良好,在撰写本文时情况仍然良好。

结论

对于出现心理健康问题的个体,应考虑诊断为复杂性创伤后应激障碍,特别是当个体的症状不符合经典诊断标准或对传统治疗无反应时。需要注意文化背景的作用——这可能导致复杂性创伤后应激障碍出现独特的表现形式,并且触发事件可能并非传统上定义的创伤性事件。文化背景也可能为复杂性创伤后应激障碍的治疗和未来预防策略提供信息。

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