強迫癥的臨床表現(xiàn)有哪些?

What are the clinical manifestations of obsessive-compulsive disorder?

強迫癥的基本癥狀是強迫觀念和強迫動作，患者可僅有強迫觀念或強迫動作，或既有強迫觀念又有強迫動作?；颊吣艹浞值卣J識到這種強迫觀念和強迫動作是不必要的，但卻不能以主觀意志加以控制。由于強迫癥狀的出現(xiàn)，患者可伴有明顯不安和煩惱，但有強烈的求治欲望、自知力保持完整。臨床上根據(jù)其表現(xiàn)，大體可將強迫癥劃分為強迫觀念及強迫行為兩類。

The basic symptoms of obsessive-compulsive disorder are obsessive thoughts and compulsive actions. Patients may have only obsessive thoughts or compulsive actions, or both obsessive thoughts and compulsive actions. Patients can fully realize that such obsessions and compulsive actions are unnecessary, but they cannot be controlled by subjective will. Due to the appearance of obsessive-compulsive symptoms, patients may be accompanied by obvious anxiety and annoyance, but there is a strong desire for treatment and self-knowledge to remain intact. According to its clinical manifestations, obsessive-compulsive disorder can be roughly divided into obsessive-compulsive concepts and compulsive behaviors.

 (1)強迫觀念 表現(xiàn)為反復而持久的觀念、思想、印象或沖動念頭。力圖擺脫，但為擺脫不了而緊張煩惱、心煩意亂、焦慮不安和出現(xiàn)一些軀體癥狀。強迫觀念可有下面幾種表現(xiàn)形式。

(1) Obsessive-compulsive ideas are expressed as repeated and lasting ideas, thoughts, impressions or impulsive thoughts. Trying to get rid of, but being nervous, upset, anxious, and showing some physical symptoms to get rid of it. Obsessions can have the following manifestations.

①強迫思想：強迫性懷疑，患者對已完成的事情總是放心不下，要反復多次檢查確實無誤后才能放下心來。如懷疑是否關好門窗，準備投寄的信是否已寫好地址，煤氣是否已關好等等，在懷疑的同時常伴有明顯的焦慮；強迫性回憶，患者對過去的經(jīng)歷、往事等反復回憶，雖知毫無實際意義，但總是反復回縈于腦中，無法擺脫，因而感到厭煩之極。如回憶已講過的話用詞、語氣是否恰當?shù)?；強迫?lián)想，當患者聽到、見到或想到某一事物時，就不由自主地聯(lián)想起一些令人不愉快或不祥的情景，如見到有人抽煙就想到火災；強迫性窮思竭慮，患者對一些毫無現(xiàn)實意義的問題，總是無休止地思考下去，盡管患者的邏輯推理正常，自知力也完整，也知道沒有必要深究，但無法克制。如天為什么要下雨?人為什么要吃飯?地球為什么是圓的?等等。

① Obsessive thoughts: Obsessive suspicion. Patients always feel uneasy about what has been done. They have to repeatedly check to be correct before they can feel relieved. If you doubt whether the doors and windows are closed, whether the letter to be posted has been addressed, whether the gas is turned off, etc., doubts are often accompanied by obvious anxiety; obsessive recollection, the patient repeats the past experience, past events, etc. Memories, although knowing that they have no practical meaning, are always lingering in the mind repeatedly, unable to get rid of it, so I feel extremely bored. Such as recalling the words used in the words and whether the tone is appropriate, etc.; forced association, when the patient hears, sees or thinks of something, he can not help but think of some unpleasant or ominous scenes, such as seeing someone smoking Just think of fire; compulsively and exhaustively, the patient always thinks endlessly about some meaningless problems. Although the patient's logical reasoning is normal and his insight is complete, he also knows that there is no need to go into it, but he cannot restrain it. . Why does it rain? Why do people eat? Why is the earth round? Wait.

②強迫意向：患者在出現(xiàn)某種正常心理時常出現(xiàn)相反的違背自己的內(nèi)心意愿，雖然這種相反的意愿十分強烈，但從不會付諸行動。如過馬路時，想到?jīng)_向正在駛過的汽車等等。

②Compulsive intention: When the patient has a certain normal mentality, he often appears contrary to his inner will. Although this opposite will is very strong, it never takes action. For example, when crossing the road, thinking of rushing towards a passing car, etc.

③強迫情緒：患者對某些事物感到厭惡或擔心，明知根本無必要卻不能克制。例如，擔心自己會傷害別人，擔心自己會說錯話，擔心自己受到毒物的污染或細菌的侵襲等。

③Compulsive emotion: The patient feels disgusted or worried about certain things, knowing that it is not necessary at all but cannot restrain it. For example, worry that you will hurt others, worry that you will say the wrong thing, worry that you will be contaminated by poisons or attacked by bacteria.

(2)強迫動作 又稱強迫行為。

(2) Forced action is also called compulsive action.

①強迫洗滌：常見有強迫洗手、洗衣等。如有位醫(yī)院掛號員，她認為接觸一些腫瘤病人的門診卡可以“傳染”到腫瘤，如她的手再接觸到家門把手，則認為會間接傳染給自己家人。于是每次下班回家總是喊家人開門，她則高舉雙手進入，然后反復洗手，內(nèi)、外衣服全部換洗，直到深更半夜才吃點夜餐就寢。

① Forced washing: forced hand washing and laundry are common. If there is a hospital attendant, she thinks that contact with some cancer patients' outpatient cards can "infect" the tumor, if her hand touches the door handle, she thinks it will indirectly infect her family. So every time she goes home from get off work, she always asks her family to open the door. She raises her hands to enter, and then washes her hands repeatedly, changing all the clothes inside and outside, until late at night before eating dinner and going to bed.

②強迫檢查：是患者為減輕強迫懷疑引起的焦慮不安而采取的措施，如出門時反復檢查門窗是否關好，寄信時反復檢查信中的內(nèi)容，看是否寫錯了字等等。

②Compulsive examination: It is the measures taken by the patient to reduce the anxiety caused by the obsessive suspicion, such as repeatedly checking whether doors and windows are closed when going out, checking the content of the letter repeatedly when sending a letter, and seeing whether it has written a wrong word, etc.

③強迫性儀式動作：患者總是做一些具有象征性福禍兇吉的固定動作，試圖以此來減輕或防止強迫觀念所引起的焦慮不安，如以手拍胸部，以示可逢兇化吉等。

③Compulsive ritual actions: The patient always does some fixed actions with symbolic blessings and bad luck, trying to reduce or prevent the anxiety caused by obsessive thoughts, such as patting the chest with a hand to show that it can be a good thing. Wait.

④強迫計數(shù)：患者見到某些具體對象

④Forced counting: the patient saw some specific objects

 (如電桿、臺階、汽車、牌照等)時，不可克制地計數(shù)，如不計數(shù)，患者就會感到焦慮不安。

(Such as electric poles, steps, cars, license plates, etc.), count without restraint. If you don't count, the patient will feel anxious.

強迫癥狀有時嚴重，有時減輕。當患者心情欠佳、傍晚、疲勞或體弱多病時較為嚴重。女性患者在月經(jīng)期間，強迫癥狀可加重。而在患者心情愉快、精力旺盛或工作、學習緊張時，強迫癥狀可減輕。

Sometimes obsessive-compulsive symptoms are severe and sometimes lessened. It is more serious when the patient is in a bad mood, in the evening, tired or frail. In female patients, obsessive-compulsive symptoms can get worse during menstruation. When the patient is happy, energetic, or stressful at work or study, obsessive-compulsive symptoms can be reduced.

 

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