适应障碍伴焦虑共病强迫型人格特质(乳腺癌术后)的访谈与治疗
|
摘要
一位39岁未婚未育女性咨客主诉出汗多、眼皮跳、乳腺癌术后担忧结婚、生育、房子以及自己的健康。咨客存在焦虑和强迫型人格特质的遗传倾向,并在学习和工作中表现出明显的追求完美,缺少弹性等特征。咨客自10年前开始出现植物神经功能的紊乱、内分泌系统的失调和病变。在1年前受到乳腺癌打击之后,焦虑症状加重,影响睡眠以及工作和生活的能力。医生的诊断是适应障碍伴焦虑共病强迫型人格特质,同时因为咨客的焦虑均与主题线相关,遂与广泛性焦虑障碍进行鉴别。在干预措施上,应采用药物治疗、运动减压、认知行为治疗和正念减压治疗等。此外,医生还建议咨客选择压力比较小、不突击、不加夜班的工作作为社会学干预。
A 39-year-old unmarried female client complains of excessive sweating and eyelid spasms. The client also has concerns about her marriage,fertility,house,and her health after a breast cancer operation. The client has a genetic predisposition for anxiety and obsessive-compulsive personality trait. She shows clear traits of perfectionism,lack of flexibility and other characteristics in her study and work. The client began experiencing autonomic dysfunction,endocrine system disorders and pathological changes ten years ago. After being diagnosed with breast cancer a year ago,the client's symptoms of anxiety grew worse and affected her sleep and the ability to work and live. The client was diagnosed with adjustment disorder with anxiety comorbid with obsessive-compulsive personality trait. Meanwhile,the client 's anxiety is related to the client 's family medical history,so it is different from generalized anxiety disorder. Interventions should include combination different medication,exercise decompression therapy,cognitive behavioral therapy,and mindfulness decompression therapy,and so on. In addition,the doctor recommends that the client chooses a low-stress job with routine tasks and no night shifts as sociological intervention.
A 39-year-old unmarried female client complains of excessive sweating and eyelid spasms. The client also has concerns about her marriage,fertility,house,and her health after a breast cancer operation. The client has a genetic predisposition for anxiety and obsessive-compulsive personality trait. She shows clear traits of perfectionism,lack of flexibility and other characteristics in her study and work. The client began experiencing autonomic dysfunction,endocrine system disorders and pathological changes ten years ago. After being diagnosed with breast cancer a year ago,the client's symptoms of anxiety grew worse and affected her sleep and the ability to work and live. The client was diagnosed with adjustment disorder with anxiety comorbid with obsessive-compulsive personality trait. Meanwhile,the client 's anxiety is related to the client 's family medical history,so it is different from generalized anxiety disorder. Interventions should include combination different medication,exercise decompression therapy,cognitive behavioral therapy,and mindfulness decompression therapy,and so on. In addition,the doctor recommends that the client chooses a low-stress job with routine tasks and no night shifts as sociological intervention.
引文
[1]美国精神医学学会.精神障碍诊断与统计手册[M].第5版.张道龙,刘春宇,等译.北京:北京大学出版社,2015:278-280,662-670.
[2]迈克尔·弗斯特.DSM-5鉴别诊断手册[M].张小梅,张道龙,译.北京:北京大学出版社,2016:59-60,147.
[3]美国精神医学学会.理解DSM-5精神障碍[M].夏雅俐,张道龙,译.北京:北京大学出版社,2016:110-111,246-247.
[2]迈克尔·弗斯特.DSM-5鉴别诊断手册[M].张小梅,张道龙,译.北京:北京大学出版社,2016:59-60,147.
[3]美国精神医学学会.理解DSM-5精神障碍[M].夏雅俐,张道龙,译.北京:北京大学出版社,2016:110-111,246-247.