Admittedly with some bias as a coauthor for several of the included articles, I am pleased to see this collection of work that will set the stage for growth in research and clinical services for veterans with obsessive-compulsive disorder (OCD) who are woefully underrecognized and inadequately treated. In the first article of the series, Dr.McIngvale and colleagues highlight the large numbers of veterans and active-duty military with OCD whose diagnoses are unrecognized in traditional care settings, and the article emphasizes the need for improved screening and assessment. Although widespread OCD screening of all veterans seeking care in Veterans Health Administration (VHA) may not be feasible given low prevalence relative to other mental health conditions (e.g., depression, posttraumatic stress disorder [PTSD], substance-use disorders [SUDs]), high comorbidity of OCD with these other disorders strongly suggests the importance of routine screening for OCD at least in mental health specialty settings. Evidence-based tools exist to facilitate this effort, although data are lacking with regard to psychometric properties of these measures in veteran populations. The McIngvale et al. review also strikingly points out the severe dearth of treatment research to evaluate the effectiveness of evidence-based treatments among veterans with OCD. In fact, not a single clinical trial was identified in a highly systematic search of the literature. As noted in the introduction to this special issue, clinical trials of other disorders suggest treatments effective for mental health conditions in civilians are not always effective for veterans (e.g., Barrera et al., 2015; Mohr, Carmody, Erickson, Jin, & Leader, 2011). Unique symptoms and characteristics of veterans and the systems in which they receive care call for innovative approaches to the content and delivery of treatment. Thus, the field calls loudly for research that will help us establish best practices for these veterans and their active-duty counterparts. The intervention case studies included in this special issue (Siffert et al.; Minac et al.) nicely describe the integration of standard OCD care into VA clinical settings and highlight potentially important modifications to address the needs of older veterans and those who live in rural locations. Of particular value for these individuals may be the use of telehealth and home-based care, incorporation of self-help materials, and the integration of specific OCD-related treatment into broader intervention models that address a range of physical and mental health needs (e.g., home-based primary care). Pdf_Folio:8

中文翻译：

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退伍军人的强迫症：讨论和未来方向。

诚然，作为其中几篇文章的合著者有一定偏见，我很高兴看到这一系列工作将为强迫症（OCD）退伍军人（其遭受严重误解和认识不足）奠定研究和临床服务增长的基础处理不当。在该系列的第一篇文章中，McIngvale博士及其同事着重介绍了许多患有强迫症的退伍军人和现役军人，他们的诊断在传统护理环境中是无法识别的，并且该文章强调需要改进筛查和评估。尽管鉴于相对于其他心理健康状况（例如抑郁症，创伤后应激障碍[PTSD]，物质使用障碍[SUDs]）的患病率较低，在退伍军人卫生管理局（VHA）中对所有寻求护理的退伍军人进行广泛的OCD筛查可能不可行，强迫症与其他疾病的高合并症强烈表明，至少在精神卫生专业领域，常规筛查强迫症的重要性。尽管缺乏有关退伍军人人群中这些措施的心理计量学特性的数据，但仍存在基于证据的工具来促进这项工作。McIngvale等。综述还引人注目的是指出缺乏治疗研究以评估强迫症退伍军人中循证治疗的有效性。实际上，在对文献进行高度系统的检索中，没有发现任何一项临床试验。如本期特刊导言所述，其他疾病的临床试验表明，对平民的心理健康状况有效的治疗方法并不总是对退伍军人有效（例如Barrera等，2015； Mohr，Carmody，Erickson，Jin，＆Leader，2011）。退伍军人的独特症状和特征以及他们得到护理的系统要求对治疗的内容和提供创新的方法。因此，该领域强烈呼吁进行研究，以帮助我们为这些退伍军人及其现役同行建立最佳实践。本期特刊（Siffert等人; Minac等人）中的干预案例研究很好地描述了将标准OCD护理整合到VA临床环境中的情况，并强调了可能进行的重要修改以解决老年退伍军人和农村居民的需求位置。对于这些人而言，特别有价值的是使用远程医疗和家庭护理，合并自助材料，以及将与强迫症相关的特定治疗方法整合到更广泛的干预模型中，以解决一系列身心健康需求（例如，基于家庭的初级保健）。Pdf_Folio：8