Ko S M
Department of Psychological Medicine, National University Hospital, Singapore.
Singapore Med J. 1996 Apr;37(2):186-8.
Until recently, obsessive compulsive disorder (OCD) was thought to be a rare condition. Once viewed predominantly as a manifestation of psychodynamic conflict, OCD is now considered a model neuropsychiatric disorder. While clear differences exist between OCD patients and normal controls, there are more similarities between OCD and Tourette's Syndrome than most other neurotic disorders in neurological signs, electrophysiology and neuropsychology. These include a lack of laterality, bilateral or dominant (left) frontal lobe dysfunction, shortened REM latency in sleep electroencephalogram, shortened latency of N200 and P300 components in visual evoked potentials, abnormal glucose metabolism in the caudate nucleus, and greater ventricle to brain ratios in OCD patients. Neuropharmacological and neuroendocrinological researches have increasingly shown that serotonin plays an important role in the complex aetiology in OCD. Finally, psychopharmacological trials have consistently demonstrated the effectiveness of the selective serotonin reuptake inhibitors in the treatment of OCD.
直到最近，强迫症（OCD）都被认为是一种罕见的病症。强迫症曾主要被视为心理动力冲突的一种表现，而现在它被视作一种典型的神经精神障碍。虽然强迫症患者与正常对照组之间存在明显差异，但相较于大多数其他神经症，强迫症与妥瑞氏综合征在神经体征、电生理学和神经心理学方面有更多相似之处。这些相似之处包括缺乏偏侧优势、双侧或优势（左侧）额叶功能障碍、睡眠脑电图中快速眼动睡眠潜伏期缩短、视觉诱发电位中N200和P300成分的潜伏期缩短、尾状核葡萄糖代谢异常，以及强迫症患者的脑室与脑体积比值更大。神经药理学和神经内分泌学研究越来越多地表明，血清素在强迫症复杂的病因中起着重要作用。最后，心理药理学试验一直证明选择性血清素再摄取抑制剂在治疗强迫症方面的有效性。
