This review evaluates current knowledge about obsessive-compulsive disorder (OCD), with the goal of providing a roadmap for future directions in research on the psychopharmacology of the disorder. It first addresses issues in the description and diagnosis of OCD, including the structure, measurement, and appropriate description of the disorder and issues of differential diagnosis. Current pharmacotherapies for OCD are then reviewed, including monotherapy with serotonin reuptake inhibitors and augmentation with antipsychotic medication and with psychologic treatment. Neuromodulatory therapies for OCD are also described, including psychosurgery, deep brain stimulation, and noninvasive brain stimulation. Psychotherapies for OCD are then reviewed, focusing on behavior therapy, including exposure and response prevention and cognitive therapy, and the efficacy of these interventions is discussed, touching on issues such as the timing of sessions, the adjunctive role of pharmacotherapy, and the underlying mechanisms. Next, current research on the neurobiology of OCD is examined, including work probing the role of various neurotransmitters and other endogenous processes and etiology as clues to the neurobiological fault that may underlie OCD. A new perspective on preclinical research is advanced, using the Research Domain Criteria to propose an adaptationist viewpoint that regards OCD as the dysfunction of a normal motivational system. A systems-design approach introduces the security motivation system (SMS) theory of OCD as a framework for research. Finally, a new perspective on psychopharmacological research for OCD is advanced, exploring three approaches: boosting infrastructure facilities of the brain, facilitating psychotherapeutic relearning, and targeting specific pathways of the SMS network to fix deficient SMS shut-down processes.

中文翻译：

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强迫症的心理药理学：临床前路线图。

这篇综述评估了关于强迫症（OCD）的当前知识，目的是为该病的心理药理学研究提供未来方向的路线图。它首先解决了强迫症的描述和诊断问题，包括疾病的结构，测量和适当描述以及鉴别诊断问题。然后审查了当前用于强迫症的药物治疗方法，包括使用5-羟色胺再摄取抑制剂的单药治疗以及使用抗精神病药物和心理治疗进行的增强治疗。还描述了用于强迫症的神经调节疗法，包括心理外科手术，深部脑刺激和无创性脑刺激。然后审查了强迫症的心理疗法，重点是行为疗法，包括接触和预防反应以及认知疗法，并讨论了这些干预措施的功效，涉及会议的时间安排，药物治疗的辅助作用以及潜在的机制等问题。接下来，检查了有关强迫症神经生物学的最新研究，包括研究各种神经递质和其他内源性过程及病因的作用，以此作为可能导致强迫症的神经生物学缺陷的线索。利用“研究领域标准”提出了一种适应主义者的观点，将OCD视为正常动机系统的功能障碍，从而提出了临床前研究的新观点。系统设计方法引入了OCD的安全激励系统（SMS）理论作为研究框架。最后，对OCD的心理药理学研究提出了新的观点，探索了三种方法：