Stein D J, Bouwer C, van Heerden B
Department of Psychiatry, University of Stollenbosch, Tygerberg, W. Cape.
S Afr Med J. 1996 Dec;86(12 Suppl):1586-8, 1591-2.
The concept of a spectrum of obsessive-compulsive related disorders may have clinical and research heuristic value in the approach to disorders similar to obsessive-compulsive disorder (OCD) in respect of phenomenology and psychobiology. Like other repetitive and ritualistic behaviours, pica may be postulated to fall at times on this spectrum.
Five cases of pica seen at our clinics are presented here in order to test this hypothesis. Phenomenology, neurobiology (where available) and pharmacotherapy data are provided in order to consider a possible relationship with OCD and OCD spectrum disorders.
In 2 of the cases, pica appeared to be a compulsion and patients had additional symptoms which met diagnostic criteria for OCD. In 2 of the cases, the clinical picture and neurobiological data were reminiscent of an impulse control disorder. Four of the 5 patients responded to treatment with a serotonin re-uptake inhibitor (SRI).
These results are consistent with a hypothesis that at least some cases of pica may usefully be conceptualised as lying within a compulsive-impulsive spectrum of symptoms and disorders.
强迫相关障碍谱系的概念在处理与强迫症（OCD）在现象学和心理生物学方面相似的障碍时，可能具有临床和研究启发价值。与其他重复和仪式化行为一样，异食癖有时可能被假定处于这个谱系之中。
本文展示了在我们诊所见到的5例异食癖病例，以检验这一假设。提供了现象学、神经生物学（如有）和药物治疗数据，以便考虑与强迫症及强迫症谱系障碍的可能关系。
在2例病例中，异食癖似乎是一种强迫行为，患者还有符合强迫症诊断标准的其他症状。在2例病例中，临床表现和神经生物学数据让人联想到冲动控制障碍。5例患者中有4例对5-羟色胺再摄取抑制剂（SRI）治疗有反应。
这些结果与以下假设一致，即至少部分异食癖病例可有效地被概念化为处于强迫-冲动症状和障碍谱系之中。
