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一例多维整合治疗成人重度强迫症的案例
引用本文:石中永,梅馨纯,竺映波,帅瑜,陈宇鹏,吴宇洁,申远.一例多维整合治疗成人重度强迫症的案例[J].上海精神医学,2017(5):304-309.
作者姓名:石中永  梅馨纯  竺映波  帅瑜  陈宇鹏  吴宇洁  申远
摘    要:概述:强迫症(OCD)是一种慢性、痛苦和进行性损害的神经精神疾病,其特点是存在强迫意念或强迫动作.本文报道的一名44岁成年女性强迫症的病例.之前3年治疗中,患者对数个选择性5-羟色胺再摄取抑制剂(SSRIs)疗效不佳,生活质量受到严重影响.经过6个月的多维整合治疗,包括认知行为治疗(CBT)、舍曲林和低剂量抗精神病药物(阿立哌唑),以及家庭支持和网络支持.每两个月Yale-Brown Obsessive-Compulsive Scale(Y-BOCS)标准化量表评估显示,强迫意念或强迫动作明显减少,其社会功能和生活质量得到明显改善.本病例初步显示OCD多维整合治疗有助于达到最佳治疗疗效较好治疗效果,期待今后更严格的临床试验验证.

关 键 词:强迫症  心理治疗  精神药理学

Multidimensional Approaches for A Case of Severe Adult Obsessive - Compulsive Disorder
Zhongyong SHI,Xinchun MEI,Yingbo ZHU,Yu SHUAI,Yupeng CHEN,Yujie WU,Yuan SHEN.Multidimensional Approaches for A Case of Severe Adult Obsessive - Compulsive Disorder[J].Shanghai Archives of Psychiatry,2017(5):304-309.
Authors:Zhongyong SHI  Xinchun MEI  Yingbo ZHU  Yu SHUAI  Yupeng CHEN  Yujie WU  Yuan SHEN
Abstract:Summary: Obsessive-compulsive disorder (OCD) is a chronic, distressing and substantially impairing neuropsychiatric disorder, characterized by obsessions or compulsions. The current case describes a 44-yearold adult female diagnosed with OCD. The patient had an incomplete response to several SSRIs alone during her past treatment, and led a poor-quality life for at least three years. Current multidimensional approaches, including combined cognitive behavioral therapy (CBT) and the Selective Serotonin Reuptake Inhibitor (SSRI, Sertraline) with a small dose of antipsychotics (Aripiprazole) for augmentation, as well as familial support and resources from the internet were provided for the patient for six months. Standardized assessments with Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) every two months indicated significant reductions in obsessive and compulsive symptoms, with significant improvements in her social functioning and quality of life. A case such as this one provides preliminary support to multidimensional approaches for OCD treatment in order to achieve an optimal response, though further rigorous clinical trials are needed to provide more evidence.
Keywords:Obsessive-compulsive disorder  Psychotherapy  Psychopharmacology
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