躯体变形障碍的临床访谈与治疗  

Interview and treatment of a case with body dysmorphic disorder

作　　者：李高飞 李苗 张道龙 Li Gaofei;Li Miao;Zhang Daolong(Beijing Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 100039,China;Beijing Huayou Psychiatric Hospital,Beijing 102200,China)

机构地区：[1]北京市中西医结合医院,北京100039 [2]北京华佑精神康复医院,北京102200

出　　处：《四川精神卫生》2021年第3期272-276,279,共6页Sichuan Mental Health

摘　　要：本文对躯体变形障碍的咨客进行案例报告,目的是提高精神科临床工作者的临床访谈技巧、诊疗思路及治疗方案的制定。咨客17岁,未婚男性,因为对自己的相貌不满意、自卑来访。咨客在学习环境转换后,出现对外貌的过度关注,伴情绪差。咨客被诊断为躯体变形障碍。建议采用生物-心理-社会综合干预的方法,生物治疗方面,给予舍曲林联合喹硫平,改善咨客的焦虑抑郁情绪和认知。心理治疗方面,采用正念减压和认知行为治疗,帮助咨客学会放松,纠正认知偏差。社会资源方面,鼓励家属积极关注咨客的优点,加强校园内课业管理,促进咨客自信心的发展。This paper reported a case of patient with body dysmorphic disorder in order to improve the clinical interview skills,diagnosis and treatment of clinicians in psychiatric department.The client was a 17-year-old unmarried male,came for psychological consultation because he was not satisfied with his appearance and had low self-esteem.After the changing of learning environment,the client showed excessive attention to his appearance along with low mood.The client was diagnosed with body dysmorphic disorder,and a biological-psychosocial comprehensive intervention was recommended.Sertraline combined with quetiapine was given as biotherapy to improve his mood and cognition.The psychotherapy included mindfulness-based stress reduction and cognitive behavioral therapy.These therapies helped the client learn to relax and correct cognitive biases.In terms of social resources,family members were encouraged to pay more attention to the client’s advantages,and schoolwork management on campus was strengthen.These methods promoted the development of client’s self-confidence.

关 键 词：躯体变形障碍 舍曲林 喹硫平 生物-心理-社会 

分 类 号：R395.3[哲学宗教—心理学]