الفهرس | Only 14 pages are availabe for public view |
Abstract The concept of the obsessive-compulsive spectrum (OCS) asserts that several disorders that have been variously categorized in the DSM share important features of OCD and are therefore related . The unifying feature of the OCS is an inability to regulate behavior. Although opinion differs on the definition of these disorders, they are said to include trichotillomania, pathological gambling, body dysmorphic disorder ,hypochondarisis, eating disorder(anorexia nervosa, bulimia) sexual compulsion ( non paraphilic sexual addiction) ,trourette syndrome , obsessive compulsive personality disorders and autism. The Criteria for inclusion in the spectrum are symptom profile : (characterized by intrusive obsessive thoughts or repetitive behaviors) , shared associated features (demographics , family history , comorbidity , clinical course) ,neurobiology, response to selective antiobsessional behavioural therapies and pharmacotherapies . and aetiology ( genetic , environmental ). OCD spectrum hypothesis has several important implications for our classification systems . First, this hypothesis generally implies that spectrum members should be classified together in DSM and that disorders have a shared pathogenesis .The spectrum hypothesis also has potentially valuable treatment implications A dimensional model has been proposed to explain the relation between the different putative obsessive compulsive spectrum disorders. So three dimensional approaches have been suggested to encompass a wide variety of neuro-psychiatric conditions sharing core pathology of obsession or compulsion . Inspite of similarities found between the OCSD and the OCD there were differences as regards : Symtomaotology (they were different in the themes for obsession &compulsion , the estimation of harm either overestimation or underestimation , type of reinforcement either +ve or –ve , the egodystonic or egosyntonic features ) , age of onset ,gender. So some authors suggested that it would be premature to include this grouping of disorders in DSM currently inspite of its considerable face validity and practical clinical utility. Additional research is needed to resolve these spectrum-related controversies. We need more investigation, about the OCSD phenotypes, etiology , pathophysiology, garnered from imaging, genetics, and neurochemistry studies. |