Obsessive compulsive disorders (OCD) are a nosographic entity. Their biological rating in serotonergic pathways and the efficacy of serotonergic antidepressants allows for developing a clinical and biological models of OCD. J. Guyotat, one of the first in 1959 to observe the favorable effects of antidepressants on OCD, presents their history. Epidemiological surveys conducted since 1980 have shown that the prevalence of OCD was underestimated until then. The prevalence is 2 to 3% in the adult population, with more women affected. The disorder develops early in childhood and adolescence. Loss of time is an important criteria for OCD but, according to M. Bourgeois, who reviewed the symptoms precisely, this does not warrant identifying a separate "primary obsessive slowness" syndrome. According to M. Bouvard, the prognosis of the disorder, in contrast to that for rituals observed in children between 3 and 5 years of age, is poor, with a risk of chronicity and social disturbances. The prevalence of OCD in children and adolescents is 0.8% and remains stable. The comorbidity, in particular with tics, is discussed. The favorable effects of fluoxetine are reported. J.M. Chignon reviews the concept of comorbidity, developed in internal medicine, and explains that it could be rigorously applied to psychiatry only starting with the DSM III-R. The comorbidity of OCD with other psychiatric diseases is highly variable: it is reviewed for personality disorders (0 to 55%), schizophrenia (4%), substance abuse (10%) and especially depression: one third of patients with OCD will develop a major depressive episode. Based on a clinical case report, M. Faruch leads us from symptoms to behavior therapy. The symptom must be considered for itself, whether it is part or not of the obsessive neurosis. It is legitimate to use antidepressants in combination with behavior therapy.
强迫症是一种疾病分类实体。其在血清素能通路中的生物学特性以及血清素能抗抑郁药的疗效有助于建立强迫症的临床和生物学模型。J. 居约塔是1959年最早观察到抗抑郁药对强迫症有良好疗效的人之一，他介绍了其历史。自1980年以来进行的流行病学调查表明，在此之前强迫症的患病率被低估了。成年人群中的患病率为2%至3%，女性受影响更多。该疾病在儿童期和青少年期早期发病。时间损耗是强迫症的一个重要标准，但根据精确审查症状的M. 布尔乔亚的说法，这并不足以确定一种单独的“原发性强迫性迟缓”综合征。根据M. 布瓦尔的说法，与3至5岁儿童中观察到的仪式行为不同，该疾病的预后很差，有慢性化和社会功能障碍的风险。儿童和青少年中强迫症的患病率为0.8%且保持稳定。文中讨论了共病情况，特别是与抽动症的共病。报告了氟西汀的良好疗效。J.M. 希尼翁回顾了在内科发展起来的共病概念，并解释说只有从《精神疾病诊断与统计手册》第三版修订本开始，它才能严格应用于精神病学。强迫症与其他精神疾病的共病情况差异很大：文中对人格障碍（0%至55%）、精神分裂症（4%）、物质滥用（10%）尤其是抑郁症的共病情况进行了综述：三分之一患有强迫症的患者会出现重度抑郁发作。基于一份临床病例报告，M. 法鲁什带领我们从症状走向行为疗法。必须就症状本身进行考量，无论它是否属于强迫性神经症的一部分。将抗抑郁药与行为疗法联合使用是合理的。
