The Theoretical And Clinical Study Of The Treatment Of Obsessive-compulsive Disorder According To The Fear

BackgroundObsessive-compulsive disorder(OCD)is a common mental disorder in psychiatric and psychological counseling outpatients,which is dominated by obsessions and compulsions.The patients feel the uncontrollable repeated thoughts or impulses from his own and take behaviors which not make sense.It is very anxious and painful.And it will negatively affect the social function and daily life,bring living burdens to the families.The condition is associated with anxiety disorder,and an increased risk of suicide.According to the WHO survey,OCD is one of the 20 most serious burdens in the middle-aged and young people.Through the literature review,it was found that fear was the factor of the occurrence and development of compulsive symptoms.The psychological,physiological and pathological mechanism of OCD was related to fear and the fear experience in childhood.The theory of fear in the application of phobia and post-traumatic stress disorder were more mature.If the thought and method of adjusting the fear of emotion are applied to the treatment of obsessive-compulsive disorder,the clinical effect may be improved.It is of great significance to enrich the cognition of the psychology of traditional Chinese medicine to OCD.Objective1.To make clear of the understanding of the fear emotion and OCD in TCM,and put forward the thought and treatment based on the theory.2.To provide an effective treatment plan and observe the clinical effect of the treatment of OCD from the psychology of TCM,to expand the means and ways of.Chinese medicine to treat OCD.Methods1 The theoretical ResearchIn the literature research,the methods of bibliography were used to explore the understanding and treatments of the fear and OCD in ancient medicine and historical literature,to understand the ancient comprehension of the self-development regularity of fear and OCD and provide theoretical guidance for clinical research.The scale survey and literature research complement of each other.The use of the cross-sectional and convenient sampling method.The OCD patients were selected as the research subjects.The Y-BOCS,SCL-90,MMPI and Guanganmen retrospective Personality Development Inventory(WMPI)were used as research tools.One hundred and forty-one valid questionnaires were selected.The relationship between fear and symptoms in patients with OCD,the correlation with fear in the process of their psychological development were be studied.2 The clinical studyForty-eight patients were randomly divided into the study group and the control group,24 cases in each group.The study group was treated with TIP,while the control group was treated with ERP,twice a week for 8 weeks.With Y-BOCS as the main therapeutic index,SCL-90 and MMPI were the secondary therapeutic targets to observe the improvement of OCD patients.Results1 The theoretical Research1.1 Literature studies showed that fear included internal and external fear.Therefore,fear was defined as internal and experience and external factors,and did not distinguished them by specific words in this study.The fear of emotion was related to five zang organs,wind,water,fire,phlegm and other pathological factors,psychological factors such as aspiration,desire,consideration and behavior,natural endowments and yunqi etc..The pathogenic mechanism was damaging the essence,qi,andexhausting spirits and other aspects.In ancient literature,OCD was named as Yu,heart disease,beidie,shuiyin and so on.The disease is caused by unilateral dominance of fear,fear of personality.And the cultivation of aspirations should start from the infant period.The therapeutic principle of fear-cause diseases was searching for the primary cause of disease,treating both the incidental and fundamental aspects,calming the spirits and zhi.The treatment included exposure,anxiety prevailing over fear,emotion restrain and desire adjustment,guided meditation and so on.In order to form a treatment plan for OCD,we should combine these ideas with thought imprint psychotherapy under a state with eliminated resistance.1.2 The total score of Y-BOCS,compulsive behavior factor,obsession factor and SCL-90 obsessive-compulsive factor had significantly positive correlation with the other factors of SCL-90.The total score of Y-BOCS,compulsive behavior factor,obsession factor had moderate correlation with anxiety,depression and phobias factor,SCL-90 obsessive-compulsive factor had moderate correlation with the other factors of SCL-90.Y-BOCS compulsive behavior factor had correlation with MMPI clinical scales of Pt,Sc,Ma and Si;Y-BOCS obsession factor had correlation with D,Pt,Sc and Si scales;the total score of Y-BOCS and D,Pt,Sc and Si scales were significantly correlated;SCL-90 obsessive-compulsive factor had correlation of all the subscales of MMPI except Pa and Ma.The correlation between obsessive compulsive symptoms and WMPI was investigated.Y-BOCS obsession factor was related to natural fear,interpersonal fear,childhood and youth interpersonal fear,youth inexplicable fear.The total score of Y-BOCS was related to interpersonal fear,childhood interpersonal fear,and youth's inexplicable fear.The SCL-90 obsessive-compulsive factor was associated with all dimensions.The correlation of three age stages was investigated.In their respective dimensions,each of the two adjacent age groups was correlated.The differences between the SCL-90 and the national norm were observed.And there were significant differences in all the factors.Examining the difference between MMPI of OCD patients and the national norm,the average standardized T score of Hy,Pd,Pt and D subscales were more than 60.The total of the patients was 2-3 non-protruding coding mapping.The differences of WMPI related dimensions in OCD patients and the national norm at different stages of growth were investigated.The natural fear of childhood,the inexplicable fear of youth,the interpersonal fear of all the stages were different with the norm.The OCD patients have no difference in natural fear,interpersonal fear and inexplicable fear from young to youth.And the national norm was different in every stage of respective dimensions.It indicated that OCD was related to fear in the current symptom and the development of emotion fear.It was reasonable to treat OCD from the fear emotion.1.3 In order to form a treatment plan for OCD,we should combine these ideas from ancient literature with TIP techniques.2 The clinical study2.1 Efficiency comparisonThe overall efficiency of the TIP group was higher.The cure rate of the TIP group was 42.86%,the effective rate was 33.33%,the inefficiency was 23.81%,the total effective rate was 76.19%;the cure rate of the control group was 10%,the effective rate was 40%,the inefficiency was 50%,the total effective rate was 50%,there was a significant difference between the two groups.2.2 Comparison of main indexesThe Y-BOCS total scores of the two groups were significantly different at different time,and there were significant differences of the effect between the two groups.Y-BOCS obsessive compulsive behavior score decreased in all two groups after treatment,and there was no difference between the two groups.The Y-BOCS obsession score decreased significantly in the study group..Combined with the comparison of factor scores at different time in the two groups of Y-BOCS,the obsession factor in the study group began to show difference with the control group in the fourth weeks,and the compulsive behavior factor in eighth weeks showed a difference from that in the control group.2.3 Comparison of secondary indexesThe total and all the factors of SCL-90 score were different in the study group.In the inter group comparison,the difference between the two groups in the forced and terrorist factors.The MMPI score of the study group showed differences in the K,Hs,D,Pd,Pa,Pt,Sc,and Si clinical scales.In the group comparison,the differences were found in Pa,Pt,and Sc before and after the treatment.Conclusion1.The theory of emotion is rich in theory,which has clinical practical value and guiding significance for Chinese medicine psychology.2.The fear of emotion is one of the factors in the development of OCD.It is feasible to treat OCD from the emotion of fear.3.The clinical practice should learn from the ancient theory of fear of emotion and contemporary psychology of traditional Chinese medicine technology.4.The treatment of OCD was helpful to improve the clinical effect,including decreasing the sysymptoms of compulsion and modifying the personality characteristics of the patients.5.The fear of emotional treatment enriched the understanding of OCD in TCM and psychology of TCM.And it provided new ideas of treatment with certain clinical significance.