McElroy S L, Phillips K A, Keck P E
Department of Psychiatry, University of Cincinnati College of Medicine, Ohio.
J Clin Psychiatry. 1994 Oct;55 Suppl:33-51; discussion 52-3.
A wide range of psychiatric and medical disorders have been hypothesized to be related to obsessive compulsive disorder (OCD) and thus, together, to form a family of disorders known as obsessive compulsive (or OCD) spectrum disorder. The grouping of these conditions is based on their phenomenological similarities with OCD (i.e., obsessive thinking and/or compulsive behaviors), as well as their having courses of illness, comorbidity and family history patterns, biological abnormalities, and treatment responses similar to OCD. Proposed OCD spectrum disorders have included body dysmorphic disorder, hypochondriasis, anorexia nervosa, trichotillomania, and some forms of delusional disorder, among others. However, conditions with impulsive features have also been hypothesized to belong to this family, including impulse control disorders in general, paraphilias and nonparaphilic sexual addictions, bulimia nervosa and binge eating disorder, and Tourette's disorder. We review the evidence supporting the grouping of these conditions into an OCD spectrum disorder family. We conclude that these disorders are different in some ways from OCD, but that they also have many similarities with OCD, and may therefore be related to one another and to OCD. In addition, we hypothesize that some of the differences among them may be explained in part by variation along a dimension of compulsivity versus impulsivity. Finally, because most of these conditions appear to be related to mood disorder, we hypothesize that the OCD spectrum disorder family may belong to the larger family of affective spectrum disorder.
已有多种精神疾病和医学疾病被假定与强迫症（OCD）相关，因此共同构成了一组被称为强迫性（或OCD）谱系障碍的疾病。这些病症的分组基于它们与OCD在现象学上的相似性（即强迫思维和/或强迫行为），以及它们在病程、共病情况、家族史模式、生物学异常和治疗反应等方面与OCD相似。提议纳入OCD谱系障碍的病症包括躯体变形障碍、疑病症、神经性厌食症、拔毛癖以及某些形式的妄想障碍等。然而，具有冲动特征的病症也被假定属于这个家族，包括一般的冲动控制障碍、性偏好障碍和非性偏好性成瘾、神经性贪食症和暴饮暴食障碍以及抽动秽语综合征。我们回顾了支持将这些病症归为OCD谱系障碍家族的证据。我们得出结论，这些疾病在某些方面与OCD不同，但它们也与OCD有许多相似之处，因此可能彼此相关且与OCD相关。此外，我们推测它们之间的一些差异可能部分由强迫性与冲动性维度上的变化来解释。最后，由于这些病症中的大多数似乎都与情绪障碍有关，我们推测OCD谱系障碍家族可能属于更大的情感谱系障碍家族。
