文献詳細
特集 精神神経疾患の治療とQOL
文献概要
抄録 強迫症(obsessive compulsive disorder:OCD)は,WHOによって苦痛や負担の著しい10大疾病の1つに挙げられているが,強迫症状の内容や重症度のみならず,精神科的併存症やDUIなどさまざまな臨床的要因がQOLと密接に関連している。さらに巻き込み症状を介し,家族の社会的機能や健康,そしてQOLにも著しい影響を及ぼすものである。このため,QOLのアセスメントを治療的評価基準として捉え実施することは,複雑であるOCD患者個々の病理・病態のより多角的な理解を促し,社会的・日常的機能や家族関係などでの治療的変化を反映するより実際的なアウトカム指標として,治療の最適化,さらに再発予防の点からも有効となる。一方で,二次的アウトカムであるQOLを向上させるための方策に関して,残遺症状の把握や適切な対処,曝露反応妨害法以外のCBT技法の導入や,ソーシャルサポートなど社会資源の活用方法など,OCDを巡る臨床には,まだまだ解決すべき課題が多々残存していると考えている。
参考文献
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