Obsessive-compulsive phobia
Introduction
Introduction Phobia is a neurosis in which phobia is the main clinical manifestation. The patient has a strong and unnecessary fear of certain specific subjects, accompanied by avoidance behavior. The object of fear may be single or multiple, such as animals, squares, closed rooms, ascending or social activities. The patient knows that his response is unreasonable, but it is difficult to control and recur. Adolescents and elderly people are mostly affected, and women are more common. The prevalence rate reported in the general population is 77, and the average prevalence rate in China is about 2.
Cause
Cause
The cause of phobia is unknown, but may be related to the following factors:
genetic factors
Slater et al reported that among the first-degree relatives of patients, 20% of parents and 10% of siblings had neurosis, and genetic factors may be related to the pathogenesis. It has also been pointed out that there is no evidence that heredity plays an important role in the development of the disease.
Personality factor
The patient's pre-existing personality is biased towards naive, timid, shy, dependent and introverted.
Mental factors
It plays a more important role in the pathogenesis. For example, if someone encounters a car accident, they will be afraid of riding. It may be that a situation happens on the background of anxiety, or an acute anxiety occurs in a certain situation, and it is feared and fixed to become a terrorist object. The horror of a particular object may be related to the education of the parents, the impact of the environment, and personal experience (such as being bitten by a dog and being afraid of dogs). The psychodynamics believe that terror is the result of the symbolic role and substitution of the repressed subconscious anxiety. The role of conditioned reflexes and learning mechanisms in the development of this disease is a more convincing explanation.
Examine
an examination
Related inspection
Brain CT examination
The central symptom of phobia is terror, and it causes severe anxiety and even panic due to terror. Due to the difference in terrorist objects, it can be divided into the following categories.
Social horror
Mainly afraid of appearing in front of everyone, especially for being more sensitive to being noticed. They don't dare to go to public places. They are a lack of self-confidence. They are afraid of shaking, blushing, sweating or clumsy, and they are at a loss, causing others' attention. Therefore, I am always reluctant to walk out of the quiet venue. I dare not sit down with others in the restaurant, and never sit face to face with others, especially to avoid talking with others. Red-faced horror is a more common type. As long as the patient feels shy, uneasily, embarrassed, clumsy, and slow in public, he is afraid to become the object of ridicule. Some patients are afraid to look at other people's eyes, afraid to meet other people's sights, called confrontational horror.
Simple horror
Simple terror is a common type and occurs frequently in childhood. Such as the horror of spiders, snakes or high places, darkness, thunderstorms, etc. Thunderstorm horrors are not only terrible to thunderstorms, but also may be strongly disturbed by the cloudy weather or high humidity that may cause thunderstorms. In order to relieve anxiety, take the initiative to leave these places to avoid the thunderstorm.
Square horror
Not only is it horrible in public places, but also worried that it is difficult to leave quickly in places where people gather, or feel anxious to ask for help. These public spaces include train stations, supermarkets, and hairdressers and theaters. Therefore, such patients often like to stay at home, not easy to go out, so as not to cause uncertainty, irritability.
Wilderness horror
The patient is horrified when passing through an open space, accompanied by strong anxiety and anxiety. Therefore, the patient is afraid to cross the wilderness and, in serious cases, fear to cross any building, such as fear of crossing streets, bridges, courtyards and corridors. In addition, there are still closed room terrorists who are afraid of smaller enclosed spaces, such as elevators, subway trains, passenger ships, etc. Most of the patients have chronic onset, which can last for many years, but they are gradually improved, and the general onset is easy to relieve.
Diagnosis
Differential diagnosis
The phobia is easily confused with the following diseases and needs to be identified:
Anxiety disorders: Anxiety can be without special subjects or fears of accidents that may occur in daily life, but without obvious fear and avoidance behavior. Square phobia can coexist with panic attacks; if you are worried about panic attacks and are afraid to go out, you should be diagnosed with panic attacks with square phobia.
Obsessive-compulsive disorder: Obsessive-compulsive symptoms stem from certain thoughts or concepts in the patient's heart, not fear of external things, often forced actions, and few avoidance behaviors.
Schizophrenia: There may be transient horror symptoms, but other mental symptoms exist at the same time and can be identified.
