强迫症的创伤前兆-一个案例系列

S. Vyjayanthi, M. Prashanth
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摘要

简介:创伤性事件不仅是创伤后应激障碍的前兆,也是强迫症的前兆,通常对干预有更好的结果和反应。这样的案例没有在印度次大陆背景下被描述过。方法:由一名临床医生在某创伤门诊门诊收集19例患者,通过半结构化临床评估和创伤事件(生活事件检查表)和强迫症严重程度(耶鲁布朗强迫症量表)的结构化评估,然后进行干预。讨论:在评估期间,在印度次大陆背景的具有代表性的不同人群中,在以强迫症状为主的最初表现之后,过去的创伤性事件普遍发生。非正常猝死是本系列案例中最常见的创伤性事件。这些小插曲说明了临床需要探索创伤性事件,这些创伤性事件在评估开始时可能不会被揭示出来。结论:该病例系列为延迟型创伤后强迫症在非西方人群中的构建提供了临床例证。探索在强迫症出现前几个月发生的创伤可能为强迫症的发生提供病因基础,并可能为临床方法提供比传统药物治疗更广泛的信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Trauma Precursors of Obsessive Compulsive Disorder - A Case Series
Introduction: Traumatic events are a precursor for not only post traumatic stress disorder but also obsessive compulsive disorder, which tend to have a generally better outcome and response to interventions. Such cases have not been described from an Indian sub-continental background. Methods: This case series of 19 patients were collected by a single clinician at a Trauma Focused Outpatient Clinic over a number of years through semi-structured clinical assessments and structured evaluation of traumatic events (Life Events Check List) and severity of obsessive compulsive disorders (Yale Brown obsessive compulsive scale) followed by interventions. Discussion: During assessment there was a common occurrence of past traumatic events following the initial presentation with predominantly obsessive compulsive symptoms in a diverse population representative of the Indian sub-continental background. Death due to a sudden unnatural cause was the most common traumatic events repre-senting this case series. The vignettes illustrate a clinical need to explore traumatic events that may not be revealed at the outset of the assessment. Conclusion: The case series provides clinical illustration to the construct of delayed type of post traumatic obsessive compulsive disorder in a predominantly non-western population. exploring trauma that occurred months earlier to the presentation of OCD may provide an aetiological substrate to the occurrence of OCD and may inform clinical approaches that are broader than conventional medication treatments for OCD.
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