Jenike M A, Rauch S L
Department of Psychiatry, Harvard Medical School, Boston.
J Clin Psychiatry. 1994 Mar;55 Suppl:11-7.
Although the majority of patients with obsessive compulsive disorder can be helped significantly by modern pharmacotherapy, usually in combination with behavioral techniques of exposure and response prevention, some remain very ill and refractory to treatment. Although there are few controlled data to guide the clinician on how to manage these patients, substantial anecdotal evidence suggests ways to manage them. Pharmacologic, behavioral, and neurosurgical approaches are reviewed. While researchers are seeking more effective treatments and a clearer understanding of the pathophysiology of obsessive compulsive disorder, it is important for clinicians to optimally utilize the tools currently available.
尽管大多数强迫症患者可通过现代药物疗法得到显著改善，通常还需结合暴露与反应阻止的行为技术，但仍有一些患者病情严重且治疗效果不佳。虽然几乎没有对照数据可指导临床医生如何管理这些患者，但大量轶事证据提示了管理他们的方法。本文对药物、行为和神经外科方法进行了综述。在研究人员寻求更有效治疗方法并更清楚了解强迫症病理生理学的同时，临床医生优化利用现有工具非常重要。
