| 王剑婷,肖茜,张道龙.强迫症共病疾病焦虑障碍的临床访谈[J].四川精神卫生杂志,2019,32(3):262-265.,Interview and treatment of obsessive compulsive disorder comorbidity with illness anxiety disorder[J].SICHUAN MENTAL HEALTH,2019,32(3):262-265 |
| 强迫症共病疾病焦虑障碍的临床访谈 |
| Interview and treatment of obsessive compulsive disorder comorbidity with illness anxiety disorder |
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| DOI：10.11886/j.issn.1007-3256.2019.03.014 |
| 中文关键词: 强迫症 疾病焦虑障碍 诊疗方案 心理治疗 |
| 英文关键词:Obsessive - compulsive disorder Illness anxiety disorder Treatment plan Psychological treatment |
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| 中文摘要: |
| 【摘要】 为了提高广大精神心理科医务工作者的临床访谈及诊断技能,本文对一例较特殊的合并了两种强迫谱系障碍的患者进行了案例访谈报告?这是一位27岁的男性患者,执着于练习弹钢琴十几年,仪式化的行为与执着让患者不能正常工作,成为大家眼中的怪人?离职后逐渐开始关注排便问题,纠结于便秘?腹胀等感受问题,总认为自己患有肛肠疾病,开始反复检查就诊?在检查无明显异常的情况下,反复要求行手术治疗四次以解决肛肠问题,结果越治越难受?本案例患者被诊断为强迫症共病疾病焦虑障碍,需要采取生物 -心理 -社会的综合治疗?调整以往用药,加强运动,调整饮食结构?施行强迫症一线治疗方案,焦虑缓解后进行认知行为疗法(CBT)来改善自我认知,减轻心理压力?今后工作中放弃不切实际的想法,学习应对策略,合理安排工作和生活? |
| 英文摘要: |
| In order to improve the clinical interview and diagnostic skills of the general medical workers in the department of psychiatry, this article reported a case interview of a patient comorbidity with two kinds of compulsive spectrum disorders. This is a twenty - seven - year - old male patient who was obsessed with practicing playing the piano for more than ten years. His ritualized behavior and persistence made him unable to work and became strange and weird in other people 's eyes. After quitting his job, he gradually began to think over problems with elimination, constipation, abdominal distension and other physical problems, always believed that he had anorectal diseases. He began to seek medical help repeatedly despite the absence of obvious abnormalities in examinations or test results. He requested surgical interventions on four separate occasions to address these anorectal problems and refused to believe that they were nonexistent. In this case, the patient was diagnosed with obsessive - compulsive disorder and comorbidity with illness anxiety disorder, which required a comprehensive biopsychosocial intervention. His medication was adjusted accordingly, and he was advised to strengthen his body through exercise and diet. While addressing his obsessive - compulsive disorder through this holistic approach, he was also taking cognitive behavioral therapy to ensure that his anxiety would be relieved through self- cognition and the reduction of psychological pressure. He learned to give up unrealistic ideas in future employment, to learn new coping strategies and to arrange work - life balance more reasonably. |
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