ABSTRACT
About 40% of patients with obsessive-compulsive disorder (OCD) are said to have treatment-refractory symptoms and chronic course of illness in spite of cognitive-behavior therapy and pharmacotherapy. The present purpose was to investigate factors relevant to OCD patients' chronic course and disturbed daily functions in view of human basic needs based on Maslow's hierarchy of five basic needs. Case notes of 101 outpatients with OCD (47 men and 54 women who were 18 to 55 years old) and seen on a psychiatry unit of a general hospital were studied to explore their stressful situations and identify thwarted basic needs. 84 of the 101 patients had Love Needs, and Esteem Needs (n = 47) and Safety Needs (n = 45) were next. The Poor-functioning group mainly had histories with problems of Safety Needs (70.8%), while the Good-functioning group tended to mainly have problems of Esteem Needs (51.5%) rather than Safety Needs (33.3%). 57 patients (23 men and 34 women) who were treated for more than three months were divided into two groups according to their Global Assessment of Functioning score at the final assessment (cut-off point: 61); patients in the Good-functioning group tended to have problems of higher needs.
Subject(s)
Activities of Daily Living/psychology , Obsessive-Compulsive Disorder/psychology , Stress, Psychological/complications , Adaptation, Psychological , Adolescent , Adult , Chronic Disease , Female , Hospitals, General , Humans , Japan , Male , Middle Aged , Needs Assessment , Obsessive-Compulsive Disorder/diagnosis , Psychiatric Department, Hospital , Recurrence , Retrospective Studies , Sick Role , Social EnvironmentABSTRACT
Taijin Kyofusho (TKS), a disorder characterized by a fear of interpersonal relations, and regarded as a culture-bound disorder in Japan, is related to social anxiety disorder (SAD). A variant of TKS, the 'offensive type' involves fear of offending others by one's inappropriate social behavior or appearance. Reports of offensive-type TKS have hitherto been limited to a small number of case reports. To delineate the characteristics of offensive-type TKS and to determine the patterns of fear and factors involved, we investigated 111 Japanese university students who reported feeling tense or nervous in social or interpersonal interactions. We analyzed subjects' responses to items on a scale for TKS, and isolated five factors. Cluster analysis of the factor scores revealed a group (N = 25) with symptomatic profiles that fit 'offensive-type TKS.' Despite this group's high TKS scores, their scores on the Liebowitz Social Anxiety Scale-Japanese version were relatively low. Our results suggest that the symptoms of some TKS sufferers do not fall within the SAD spectrum.
