compulsive behavior
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INTRODUCTION: The addition of compulsive sexual behavior disorder (CSBD) into the ICD-11 chapter on mental, behavioral, or neurodevelopmental disorders has greatly stimulated research and controversy around compulsive sexual behavior, or what has been termed "hypersexual disorder," "sexual addiction," "porn addiction," "sexual compulsivity," and "out-of-control sexual behavior." OBJECTIVES: To identify where concerns exist from the perspective of sexual medicine and what can be done to resolve them. METHODS: A scientific review committee convened by the International Society for Sexual Medicine reviewed pertinent literature and discussed clinical research and experience related to CSBD diagnoses and misdiagnoses, pathologizing nonheteronormative sexual behavior, basic research on potential underlying causes of CSBD, its relationship to paraphilic disorder, and its potential sexual health consequences. The panel used a modified Delphi method to reach consensus on these issues. RESULTS: CSBD was differentiated from other sexual activity on the basis of the ICD-11 diagnostic criteria, and issues regarding sexual medicine and sexual health were identified. Concerns were raised about self-labeling processes, attitudes hostile to sexual pleasure, pathologizing of nonheteronormative sexual behavior and high sexual desire, mixing of normative attitudes with clinical distress, and the belief that masturbation and pornography use represent "unhealthy" sexual behavior. A guide to CSBD case formulation and care/treatment recommendations was proposed. CONCLUSIONS: Clinical sexologic and sexual medicine expertise for the diagnosis and treatment of CSBD in the psychiatric-psychotherapeutic context is imperative to differentiate and understand the determinants and impact of CSBD and related "out-of-control sexual behaviors" on mental and sexual well-being, to detect forensically relevant and nonrelevant forms, and to refine best practices in care and treatment. Evidence-based, sexual medicine-informed therapies should be offered to achieve a positive and respectful approach to sexuality and the possibility of having pleasurable and safe sexual experiences.
- MeSH
- antidepresiva tricyklická terapeutické užití MeSH
- behaviorální terapie MeSH
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- obsedantně kompulzivní porucha diagnóza farmakoterapie chirurgie MeSH
- prevalence MeSH
- příznaky a symptomy MeSH
- prognóza MeSH
- serotonin patofyziologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
Nové léčby, zejména kognitivně behaviorální terapie a serotonergní léky, pomáhají zmírnit příznaky OCD. Na léčbu antidepresivy zareaguje přibližně 50 % postižených. Ovšem významný počet pacientů reaguje málo nebo zůstává s vážnou reziduální symptomatologií. Někteří z těchto pacientů mohou mít užitek z přidání malých dávek antipsychotik nebo z augmentace lithiem, buspironem. Málo zatím víme o efektivitě rTMS u této diagnózy. Chroničtí refrakterní pacienti mohou být kandidáty na neurochirurgické výkony, jako je přední cingulotomie a capsulotomie.
Newer treatments, specifically cognitive behavioral therapy and serotonergic agents, have helped significantly in symptom amelioration. It is estimated that the symptoms of approximately 50% of patients respond partially to a trial with antidepressants. Consequently, a significant number of patients are left with residual symptoms and disability. Some patients who do not respond to an SRI trial may respond upon addition of a low dose of an antipsychotics. Augmentation with other several agents such as lithium, buspirone, pindolol has been tried with variable success in soma patients. A little is known about efficacy of rTMS in this diagnosis. Chronic refractory OCD causing documented persistent, severe disability is sometimes treated palliatively with neurosurgical procedures such as anterior cingulotomy or anterior capsulotomy.
- MeSH
- dítě MeSH
- kognitivně behaviorální terapie MeSH
- komorbidita trendy MeSH
- lidé MeSH
- mladiství MeSH
- obsedantně kompulzivní porucha dějiny epidemiologie etiologie MeSH
- pohlavní hormony škodlivé účinky MeSH
- selektivní inhibitory zpětného vychytávání serotoninu MeSH
- Tourettův syndrom epidemiologie etiologie komplikace MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- behaviorální terapie metody MeSH
- dítě MeSH
- fluvoxamin terapeutické užití MeSH
- lidé MeSH
- obsedantně kompulzivní porucha terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- kazuistiky MeSH
Vztahová obsedantně kompulzivní porucha (R-OCD) je subtyp obsedantně-kompulzivní poruchy (OCD), který se projevuje neustálými pochybnostmi a úzkostmi týkajícími se intimního vztahu. Myšlení lidí s R-OCD je zaujato vtíravými myšlenkami, jejichž obsahem jsou pochybnosti, zda pocity, které chovají k partnerovi, jsou správné, zda je partner miluje, zda je vztah vhodný nebo zda má partner nějaké nedostatky. Tyto myšlenky vyvolávají nutkání k provádění rituálů v podobě opakovaných kontrol, ujišťování nebo porovnávání. Rituály vedou ke snížení úzkosti a napětí. Toto chování však vede k narušení vztahu a dlouhodobému udržování úzkosti. Článek popisuje charakteristiky R-OCD a nabízí základní strategie kognitivně behaviorální terapie (KBT), která pomáhá pacientům změnit svůj vztah k obsedantním myšlenkám a snížit nutkavé chování.
Relationship obsessive compulsive disorder (R-OCD) is a subtype of obsessive-compulsive disorder (OCD) that manifests in constant doubts and anxieties about an intimate relationship. People with R-OCD suffer from intrusive thoughts about whether they have the right feelings for their partner, whether their partner loves them, whether the relationship is suitable or whether their partner has any flaws. These thoughts trigger the urge to perform various rituals to alleviate anxiety, such as repeated checking, reassurance or comparison. However, this behaviour leads to disruption of the relationship and long-term maintenance of the anxiety. This paper described characteristics of R-OCD and offers basic cognitive-behavioural strategies that help the patients to change their attitude towards the obsessive thoughts and reduce compulsive behaviour.
- MeSH
- dospělí MeSH
- interpersonální vztahy * MeSH
- kognitivně behaviorální terapie MeSH
- lidé MeSH
- mladý dospělý MeSH
- obsedantně kompulzivní porucha * patologie psychologie terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
- MeSH
- dítě MeSH
- finanční podpora výzkumu jako téma MeSH
- kognitivně behaviorální terapie MeSH
- kombinovaná farmakoterapie MeSH
- lidé MeSH
- mladiství MeSH
- obsedantně kompulzivní porucha diagnóza patologie terapie MeSH
- sertralin farmakologie terapeutické užití MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- Publikační typ
- randomizované kontrolované studie MeSH
Úvod: Citová vazba vzniká v raném dětství mezi dítětem a primární pečující osobou a zásadním způsobem ovlivňuje sebehodnocení dítěte a jeho vnímání světa jako bezpečného místa. Cílem této přehledové studie je představit současný stav poznání týkající se vztahu mezi vazbou a obsedantně kompulzivní poruchou (OCD), průběhem poruchy a účinností léčby.
Introduction: Emotional attachment arises between the child and the primary caregiver in early childhood and fundamentally affects the child's self-esteem and their perception of the world as a safe place. The aim of this review is to present the current state of knowledge about the relationship between attachment and obsessive-compulsive disorder (OCD), the course of the disorder and the effectiveness of the treatment. Method: A literature search was performed using PubMed, Web of Science, Google Scholar, and ScienceDirect databases using key search terms. Scientific texts were extracted for the period from January 1990 to the end of March 2020. Results: An insecure attachment reduces a personal sense of self-worth and can lead to perfectionism and compulsive behavior, which becomes a means of trying to secure and stabilize the value of self-concept and control the surrounding events. Both characteristics are common in patients with OCD. Uncertain attachment is further associated with maladaptive cognitive processes (such as excessive sense of responsibility, perfectionism, and mind control), which are also associated with OCD. Of the two dimensions that define uncertain adulthood attachment (anxiety and avoidance), attachment anxiety is more closely related to OCD. No research has been described in the articles we found to prove a direct link between the attachment and the severity of OCD. Insecure emotional attachment and OCD is complicated by frequent comorbid depression. Conclusions: Anxious emotional attachment is common in patients with OCD and interconnects with basic OCD symptomatology. From this perspective, strategies that promote feelings of safety, acceptance, and appreciation within a therapeutic relationship may be important in the treatment of OCD.
AIM: The paper describes the characteristics of relationship obsessive-compulsive disorder (R-OCD), including the types of obsessions and compulsions, the common triggers and the impact on psychological well-being and relationship functioning. It also offers basic cognitive-behavioural strategies to help patients change their attitudes towards obsessive thoughts and reduce compulsive behaviours. METHODS: This article is a narrative review of the literature and case studies on R-OCD. To search for relevant sources, we used PubMed, PsycINFO and Web of Science databases with the keywords "relationship obsessive compulsive disorder", "R-OCD", "relationship OCD" and "partner-focused OCD". We included only studies published in English from January 1990 to June 2023. The paper provides examples of how basic cognitive-behavioural strategies help individuals with R-OCD. RESULTS: People with R-OCD experience intrusive thoughts about whether they have the right feelings for their partner, whether their partner loves them, whether the relationship is suitable or whether their partner has flaws. These thoughts trigger the urge to perform various rituals to alleviate anxiety, such as repeated checking, reassurance or comparison. However, this behaviour leads to disruption of the relationship and long-term maintenance of the anxiety. Examples of basic cognitive-behavioural strategies can be applied in clinical practice to help individuals change their attitudes towards relational obsessive thoughts and reduce compulsive behaviours.
