Pigott T A, L'Heureux F, Dubbert B, Bernstein S, Murphy D L
Department of Psychiatry, Georgetown University Medical School, Washington, D.C.
J Clin Psychiatry. 1994 Oct;55 Suppl:15-27; discussion 28-32.
According to DSM-IV criteria, obsessive compulsive disorder (OCD) is an anxiety disorder that is characterized by recurrent, intrusive images or thoughts and/or stereotyped, repetitive behaviors that are associated with marked distress, anxiety, or psychosocial impairment. The differential diagnosis of OCD can be quite difficult since OCD symptomatology can occur as either primary or secondary phenomena. Comorbid depression or personality disorder is not uncommon in patients with primary OCD. Other comorbid conditions that occur with OCD can be divided into three major groups based on core features: (1) disorders of altered risk assessment; (2) incompleteness/habit-spectrum disorders; and (3) psychotic spectrum disorders. Such a categorization of core dimensions and comorbid conditions may prove useful in identifying distinct OCD subtypes that share underlying neurobiological or treatment response characteristics.
根据《精神疾病诊断与统计手册》第四版标准,强迫症(OCD)是一种焦虑症,其特征是反复出现的、侵入性的意象或想法和/或刻板、重复的行为,这些行为与明显的痛苦、焦虑或社会心理损害相关。强迫症的鉴别诊断可能相当困难,因为强迫症症状既可以作为原发性现象出现,也可以作为继发性现象出现。原发性强迫症患者中合并抑郁症或人格障碍并不罕见。与强迫症同时出现的其他合并症可根据核心特征分为三大类:(1)风险评估改变的障碍;(2)不完整/习惯谱系障碍;(3)精神病谱系障碍。这种对核心维度和合并症的分类可能有助于识别具有潜在神经生物学或治疗反应特征的不同强迫症亚型。