불안장애의 경계：강박장애와 정신분열병

• 영문명: Boundary of Anxiety Disorders：Obsessive-Compulsive Disorder and Schizophrenia
• 발행기관: 대한신경정신의학회
• 저자명: 임준석 김찬형
• 간행물 정보: 『신경정신의학』제47권 제6호, 525~532쪽, 전체 8쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2008.11.30

영문 초록

Although obsessive-compulsive disorder (OCD) is recognized as a major psychiatric illness, few studies have investigated obsessive-compulsive symptoms in patients with schizophrenia. Recent increases in dual diagnosis due to changes to the DSMIV diagnostic criteria, findings of obsessive-compulsive symptoms (OCS) after administration of atypical antipsychotics, increased reports of co-occurrence of schizophrenia and OCD have increased the interest in OCS in schizophrenia. The incidence of OCS in patients with schizophrenia is reported to be 3-59%；however, the rate of progression to schizophrenia from OCD is not higher than in the general population. Level of insight, which differentiates obsessions from delusions, can be confounded by the specifier ‘with poor insight’ in OCD. OCD with schizotypal personality disorder or poor insight differs from pure OCD in that it responds poorly to treatment, has a poor prognosis, leads to deficits in cognitive functioning similar to those observed in schizophrenia, and responds well to low-dose antipsychotics. In the past, it was believed that OCS could prevent or delay the deteriorative course of schizophrenia. However, recent studies have shown that co-occurrence of OCD and schizophrenia increases the severity of symptoms, delays the treatment response, and reduces socio-occupational functions. Schizophrenia and OCD share the same pathophysiology in that both diseases have defects in the fronto-basal functional circuitry of the brain. The use of serotonin and dopamine has been addressed in schizophrenia due to the use of atypical antipsychotics in patients with schizophrenia. The finding of drug-induced OCS suggested that the two diseases share a similar pathogenesis involving neurotransmitters. Further studies are needed to make an exact diagnosis between the two diseases and to determine the common pathophysiology between OCD and schizophrenia.

목차

서 론

강박장애 환자에서 동반되는 정신분열병

강박장애 환자에서 동반되는 정신분열형 인격장애

병식이 없는 강박장애

정신분열병 환자에서 동반된 강박 증상

비전형 항정신병 약물 투여로 인해 나타난 강박증상

정신분열병 환자에서 강박 증상이 동반되었을 경우 예후에 미치는 영향

정신분열병과 강박장애의 공통 부분에 대한 기능 신경 해부학적 관점

정신분열병과 강박장애의 공통부분에 대한 신경전달물질과 관련된 관점

정신분열병과 강박장애 동반 환자의 치료

결 론

REFERENCES

키워드

Obsessive-compulsive disorder Schizophrenia