■当前指南旨在评估药物在强迫性行为障碍(CSBD)患者治疗中的作用。它们旨在由治疗CSBD患者的临床医生在临床实践中使用。
■使用PubMed和GoogleScholar索引的英语文学进行了广泛的文献检索,没有时间限制,补充其他来源,包括发表的评论。
■每个治疗建议都根据其疗效的证据强度进行评估,安全,耐受性,和可行性。心理教育和心理治疗是首选治疗方法,应始终进行。推荐的药物类型主要取决于CSBD的强度以及合并症和精神疾病。很少有随机对照试验。虽然没有药物具有CSBD的正式适应症,选择性5-羟色胺再摄取抑制剂和纳曲酮目前是治疗CSBD的最相关的药物治疗方法。在CSBD合并副嗜性疾病的病例中,可以指示荷尔蒙剂,人们应该参考以前发表的关于治疗成人嗜性疾病的指南。在与CSBD相关的化学性行为的情况下,还提出了具体建议。
■针对不同类别的CSBD患者,提出了一种具有不同治疗水平的算法。
The current
guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD.
An extensive literature search was conducted using the English-language-literature indexed on PubMed and Google Scholar without time limit, supplemented by other sources, including published reviews.
Each treatment recommendation was evaluated with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. Psychoeducation and psychotherapy are first-choice treatments and should always be conducted. The type of medication recommended depended mainly on the intensity of CSBD and comorbid sexual and psychiatric disorders. There are few randomised controlled trials. Although no medications carry formal indications for CSBD, selective-serotonin-reuptake-inhibitors and naltrexone currently constitute the most relevant pharmacological treatments for the treatment of CSBD. In cases of CSBD with comorbid paraphilic disorders, hormonal agents may be indicated, and one should refer to previously published
guidelines on the treatment of adults with paraphilic disorders. Specific recommendations are also proposed in case of chemsex behaviour associated with CSBD.
An algorithm is proposed with different levels of treatment for different categories of patients with CSBD.