合并重度抑郁症患者强迫症治疗的考虑因素
Considerations for the treatment of obsessive-compulsive disorder in patients who have comorbid major depression.
摘要(中文译文)
强迫症（OCD）是一种使人衰弱的精神疾病，影响着全球大量人群。重度抑郁症（MDD）是强迫症患者中最常见的共病之一。强迫症患者中出现重度抑郁症可归因于强迫症症状严重程度的增加及其对日常功能的深远影响。抑郁症状也可以改变强迫症的病程。在这篇综述中，作者探讨了可能同时构成强迫症和重度抑郁症基础的潜在共同神经生物学机制，如睡眠模式紊乱、免疫失调和神经内分泌变化。此外，他们还讨论了临床医生在管理强迫症与重度抑郁症共病时面临的挑战。作者还讨论了一系列与重度抑郁症相关的强迫症的治疗选择，包括5-羟色胺再摄取抑制剂的增效策略（如阿立哌唑）、心理治疗（尤其是认知行为疗法/暴露与反应预防）、经颅磁刺激（TMS）、电休克治疗（ECT）和深部脑刺激（DBS）。尽管在强迫症共病重度抑郁症的治疗中尚无“经验法则”或普遍可接受的策略，但许多临床医生，包括本文作者，倾向于采用一种独特的跨诊断方法来治疗强迫症及相关疾病，重点关注已知在不同诊断中均有效的策略。然而，现有的“同诊断方法”仍然具有重要意义，即为更严重形式的个别疾病量身定制的特定治疗策略。
Abstract
Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder that affects a significant number of individuals worldwide. Major depressive disorder (MDD) is among the most common comorbidities reported in people with OCD. The emergence of MDD in individuals with OCD can be attributed to the increased severity of OCD symptoms and their profound impact on daily functioning. Depressive symptoms can also modify the course of OCD. In this review, the authors explore potential shared neurobiological mechanisms that may underlie both OCD and MDD, such as disturbed sleep patterns, immunological dysregulations, and neuroendocrine changes. Furthermore, they address the challenges clinicians face when managing comorbid OCD and MDD. The authors also discuss a range of treatment options for OCD associated with MDD, including augmentation strategies for serotonin reuptake inhibitors (e.g. aripiprazole), psychotherapy (especially CBT/EPR), transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), and deep brain stimulation (DBS). Although there is no 'rule of thumb' or universally acceptable strategy in the treatment of OCD comorbid with MDD, many clinicians, including the authors, tend to adopt a unique transdiagnostic approach to the treatment of OCD and related disorders, focusing on strategies known to be effective across diagnoses. Nevertheless, the existing 'cisdiagnostic approaches' still retain importance, i.e. specific therapeutic strategies tailored for more severe forms of individual disorders.
如何引用
AMA
Verônica Hühne, Carina Chacur, Marcos Vinícius Sousa de Oliveira, Pedro Pereira Fortes, Gabriela M Bezerra de Menezes, Leonardo F Fontenelle. Considerations for the treatment of obsessive-compulsive disorder in patients who have comorbid major depression.. Expert review of neurotherapeutics. 2023; doi:10.1080/14737175.2023.2265066.
APA
Verônica Hühne, Carina Chacur, Marcos Vinícius Sousa de Oliveira, Pedro Pereira Fortes, Gabriela M Bezerra de Menezes, Leonardo F Fontenelle (2023). Considerations for the treatment of obsessive-compulsive disorder in patients who have comorbid major depression.. Expert review of neurotherapeutics. https://doi.org/10.1080/14737175.2023.2265066
GB/T 7714
Verônica Hühne, Carina Chacur, Marcos Vinícius Sousa de Oliveira, Pedro Pereira Fortes, Gabriela M Bezerra de Menezes, Leonardo F Fontenelle. Considerations for the treatment of obsessive-compulsive disorder in patients who have comorbid major depression.[J]. Expert review of neurotherapeutics, 2023 doi:10.1080/14737175.2023.2265066.
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