Neuropsychologie der Zwangsstörung

  • Bernd Leplow

Zusammenfassung

Eine 32-jährige Hausfrau fühlt sich vor jedem Verlassen der Wohnung gezwungen, alle elektrischen Geräte, Fenster, Türen und Wasserhähne kontrollieren zu müssen. Dieses erfolgt in genau festgelegter Abfolge: erst die vier Herdschalter (jeden einzeln fixieren und halblaut jeweils langsam und konzentriert »aus-aus-aus!« sagen), dann die Kaffeemaschine, den Wasserkocher, das Bügeleisen, Radio und Fernseher sowie die Wasserhähne (Stellung stets über einem Abfluss und Stöpsel außerhalb des Beckens), dann alle Heizkörperventile, Fenster (jedes der Reihe nach dreimal andrücken, ggf. dieses dreifach wiederholen: »dreimal, dann ist gut!«), Kühlschrank- und schließlich die Wohnungstür. Der Türgriff wird dreifach angedrückt und abschließend wird das ganze Körpergewicht gegen die Tür gestemmt. Bei Zeitdruck und anderen Formen emotionaler Belastung wird dieser Ablauf mehrfach ausgeführt. Außerdem wird jede Handlungssequenz stets wiederholt, wenn ein Teilschritt nicht mit hinreichender Konzentration ausgeführt wurde. Die Störung wurde manifest, nachdem die Patientin vergessen hatte, einen Herdschalter auszuschalten und etwa zeitgleich eine Nachbarwohnung niederbrannte. Die Kontrollhandlungen weiteten sich schnell auf eine immer größer werdende Zahl von Gegenständen aus, wobei die Rituale immer komplexer wurden. Bei Behinderung der Rituale tritt eine erhebliche, gelegentlich ängstlich getönte Unruhe auf. Diese wird sofort reduziert, wenn der Ehemann den ordnungsgemäßen Zustand der hinterlassenen Wohnung versichert.

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© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • Bernd Leplow

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