Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.858
Filtrar
1.
Nat Rev Neurosci ; 21(5): 247-263, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32231315

RESUMO

Compulsion is a cardinal symptom of drug addiction (severe substance use disorder). However, compulsion is observed in only a small proportion of individuals who repeatedly seek and use addictive substances. Here, we integrate accounts of the neuropharmacological mechanisms that underlie the transition to compulsion with overarching learning theories, to outline how compulsion develops in addiction. Importantly, we emphasize the conceptual distinctions between compulsive drug-seeking behaviour and compulsive drug-taking behaviour (that is, use). In the latter, an individual cannot stop using a drug despite major negative consequences, possibly reflecting an imbalance in frontostriatal circuits that encode reward and aversion. By contrast, an individual may compulsively seek drugs (that is, persist in seeking drugs despite the negative consequences of doing so) when the neural systems that underlie habitual behaviour dominate goal-directed behavioural systems, and when executive control over this maladaptive behaviour is diminished. This distinction between different aspects of addiction may help to identify its neural substrates and new treatment strategies.


Assuntos
Comportamento Aditivo/psicologia , Comportamento Compulsivo/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Animais , Comportamento de Procura de Droga , Humanos , Vias Neurais , Reforço Psicológico
4.
Pediatrics ; 145(2)2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32015180

RESUMO

Phenotypic and biological characterization of rare monogenic disorders represents 1 of the most important avenues toward understanding the mechanisms of human disease. Among patients with SH3 and multiple ankyrin repeat domains 3 (SHANK3) mutations, a subset will manifest neurologic regression, psychosis, and mood disorders. However, which patients will be affected, when, and why are important unresolved questions. Authors of recent studies suggest neuronal SHANK3 expression is modulated by both inflammatory and hormonal stimuli. In this case series, we describe 4 independent clinical observations of an immunotherapy responsive phenotype of peripubertal-onset neuropsychiatric regression in 4 girls with pathogenic SHANK3 mutations. Each child exhibited a history of stable, mild-to-moderate lifelong developmental disability until 12 to 14 years of age, at which time each manifested a similar, subacute-onset neurobehavioral syndrome. Symptoms included mutism, hallucinations, insomnia, inconsolable crying, obsessive-compulsive behaviors, loss of self-care, and urinary retention and/or incontinence. Symptoms were relatively refractory to antipsychotic medication but improved after immunomodulatory treatment. All 4 patients exhibited chronic relapsing courses during a period of treatment and follow-up ranging from 3 to 6 years. Two of the 4 girls recovered their premorbid level of functioning. We briefly review the scientific literature to offer a conceptual and molecular framework for understanding these clinical observations. Future clinical and translational investigations in this realm may offer insights into mechanisms and therapies bridging immune function and human behavior.


Assuntos
Transtorno do Espectro Autista/genética , Deficiências do Desenvolvimento/genética , Mutação da Fase de Leitura , Imunoterapia/métodos , Proteínas do Tecido Nervoso/genética , Comportamento Estereotipado , Adolescente , Agressão/efeitos dos fármacos , Antipsicóticos/uso terapêutico , Ansiedade , Catatonia/tratamento farmacológico , Criança , Comportamento Compulsivo/tratamento farmacológico , Choro , Feminino , Alucinações/tratamento farmacológico , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Imunossupressores/uso terapêutico , Humor Irritável/efeitos dos fármacos , Metilprednisolona/uso terapêutico , Mutismo/tratamento farmacológico , Fármacos Neuroprotetores/uso terapêutico , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Recidiva , Autocuidado , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Comportamento Estereotipado/efeitos dos fármacos , Síndrome , Incontinência Urinária , Retenção Urinária
6.
Expert Opin Pharmacother ; 21(2): 163-165, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31893946

RESUMO

Introduction: Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterized by obsessions and compulsions. Obsessions are defined as intrusive, recurrent and distressing thoughts, images or impulses, whereas compulsions are defined as repetitive behaviors or mental acts. While there is an associated distress, and indeed oftentimes, the individual's awareness that these behaviors are excessive and unreasonable, the individual continues to be disabled by an inability to cease their compulsions. The postpartum period may herald the onset of OCD or precipitate an exacerbation of the preexisting OCD symptoms. Common OCD symptom clusters occur in the postpartum period, with specific challenges associated with motherhood and lactation.Areas covered: This brief review aims to review the extent and nature of publications evaluating pharmacological treatment of OCD in the postpartum period.Expert opinion: Education and training should aim to improve the recognition and treatment of postpartum OCD. Due to the limited nature of studies, more research is required to assess the role of selective serotonin reuptake inhibitors in the postpartum period.


Assuntos
Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Período Pós-Parto , Aleitamento Materno , Comportamento Compulsivo/tratamento farmacológico , Feminino , Humanos , Transtorno Obsessivo-Compulsivo/psicologia , Inibidores de Captação de Serotonina/uso terapêutico
7.
Nat Rev Neurosci ; 21(2): 58-59, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31822865
8.
Ann Otol Rhinol Laryngol ; 129(1): 87-90, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31416334

RESUMO

OBJECTIVES: To highlight a severe case of rhinotillexomania (compulsive nasal picking) and its potential to manifest as empty nose syndrome (ENS). METHODS: A single case report with the presentation and management of a patient with severe rhinotillexomania who presented with chronic obstructive symptoms. We review the current literature on rhinotillexomania and ENS. RESULTS: This patient's manifestations mimic the obstructive symptoms of ENS, despite widely patent nasal passages. CONCLUSION: This is the first report of rhinotillexomania manifesting with features of ENS.


Assuntos
Comportamento Compulsivo/complicações , Perfuração do Septo Nasal/etiologia , Idoso , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Budesonida/uso terapêutico , Endoscopia , Humanos , Umidificadores , Masculino , Mupirocina/uso terapêutico , Obstrução Nasal , Perfuração do Septo Nasal/diagnóstico , Perfuração do Septo Nasal/terapia , Doenças Nasais/diagnóstico , Doenças Nasais/etiologia , Doenças Nasais/terapia , Síndrome , Irrigação Terapêutica , Tomografia Computadorizada por Raios X
9.
Clin Child Psychol Psychiatry ; 25(1): 98-105, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31046422

RESUMO

Research in adults demonstrates a positive association among obsessive-compulsive symptoms, eating pathology, cognitive distortions, and comorbid depressive symptoms. Given that adolescence is characterized by unique and rapid changes in biopsychosocial processes, it is imperative to elucidate the relationship between these variables in youth. In this cross-sectional study, we explored whether obsessive-compulsive symptoms, thought-action fusion, thought-shape fusion, and eating pathology would be positively associated with and predict depressive symptoms in a school-based community sample of adolescents (n = 86; Mage = 15.60). All study variables were positively correlated with depressive symptoms. Results indicated that obsessive-compulsive symptoms, thought-shape fusion, and eating pathology explained a significant proportion of variance in depressive symptoms, whereas thought-action fusion did not. In accordance with the cognitive behavioral model of psychopathology, these findings highlight the relationships between key interrelated correlates of depressive symptoms that may be pertinent targets for prevention and treatment efforts in adolescents.


Assuntos
Cognição/fisiologia , Comportamento Compulsivo/psicologia , Depressão/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Comportamento Obsessivo/psicologia , Adolescente , Comportamento Compulsivo/complicações , Estudos Transversais , Depressão/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Feminino , Humanos , Masculino , Comportamento Obsessivo/complicações , Inquéritos e Questionários
11.
Actas Esp Psiquiatr ; 47(6): 209-17, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31869421

RESUMO

INTRODUCTION: Repetitive behavior is a transdiagnostic variable that is present in many neurodevelopmental disorders. The Repetitive Behavior Scale-Revised (RBS-R) by Bodfish is one of the tests most used to evaluate repetitive behaviors in people with autism and intellectual disability. MATERIALS AND METHODS: In the present article, we analyze the differences in repetitive behavior according to the diagnosis, the interaction effects between diagnoses and gender and/or age and display the standard scores of the RBS-R for a group of people with autism, a group of people with intellectual disability and another group of people with Autism and intellectual disability. RESULTS: The results indicate that there are differences in the repetitive behavior between the groups, being greater the severity of the repetitive behaviors in people with autism associated to intellectual disability, followed by autism, and finally intellectual disability. Finally, the RBS-R percentiles according to diagnostic groups are shown. CONCLUSIONS: The RBS-R has been shown to be a useful diagnostic tool for assessing some of the main neurodevelopmental disorders, such as autism spectrum disorders and intellectual disability.


Assuntos
Transtorno do Espectro Autista/psicologia , Deficiência Intelectual/psicologia , Comportamento Estereotipado , Adolescente , Adulto , Análise de Variância , Criança , Pré-Escolar , Comportamento Compulsivo , Feminino , Humanos , Lactente , Masculino , Testes Psicológicos , Comportamento Autodestrutivo/psicologia , Espanha
13.
Artigo em Inglês | MEDLINE | ID: mdl-31766527

RESUMO

Individual characteristics, family- and school-related variables, and environmental variables have equal importance in understanding Internet addiction. Most previous studies on Internet addiction have focused on individual factors; those that considered environmental influence typically only examined the proximal environment. Effective prevention and intervention of Internet addiction require a framework that integrates individual- and environmental-level factors. This study examined the relationships between personal factors, family/school factors, perceived Internet characteristics, and environmental variables as they contribute to Internet addiction among adolescents based on the public health model. A representative sample of 1628 junior high school students from 56 regions in Seoul and Gyeonggi-do participated in the study via questionnaires with the cooperation of the Ministry of Health and Welfare and the district office of education. The study analyzed psychological factors, family cohesion, attitudes toward academic activities, Internet characteristics, accessibility to PC cafés, and exposure to Internet game advertising. About 6% of the adolescents were categorized as being in the severely addicted group. Between-group comparisons showed that the addicted group had started using the Internet earlier; had higher levels of depression, compulsivity, and aggressiveness as well as lower family cohesion; and reported higher accessibility to PC cafés and exposure to Internet game advertising. Multiple logistic regression indicated that for adolescents, environmental factors had a greater influence than family or school-related factors. Policy implications for prevention and intervention are discussed.


Assuntos
Comportamento Aditivo/epidemiologia , Meio Ambiente , Internet , Sucesso Acadêmico , Adolescente , Comportamento do Adolescente , Fatores Etários , Agressão , Comportamento Compulsivo/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Saúde Pública , República da Coreia/epidemiologia , Fatores Socioeconômicos
14.
Psychiatr Pol ; 53(4): 825-843, 2019 Aug 31.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-31760412

RESUMO

The purpose of this article is to present an overview of current knowledge on the treatment of obsessive-compulsive and obsessive-compulsive-related disorders (OCRD - according to DSM-5). The article presents commonly used pharmacological treatments and psychotherapy, as well as surgical and other forms of treatment. According to the analyses that have been made, the variety of responses to the pharmacological treatment of obsessive-compulsive disorders (OCD) depending on the kinds of symptoms is not relevant enough to justify these other forms of treatment. Instead, the choice of medication should be made based on other factors, such as the severity of symptoms and the level of insight into the illness or the symptoms of other disorders co-occurring with the obsessions. These factors are also significant in psychotherapy, but in this case, the dependency between the types of obsessions and compulsions and the therapeutic approach has greater importance. Generally speaking, in OCRD treatment, atendency to use other forms of treatment can be observed for disorders based mainly on the mechanism of compulsivity or impulsivity. Hopes for a more effective treatment are related to the types of pharmacological treatment and modifications of psychotherapeutic methods based on the development happening in the cognitive behavioural approach.


Assuntos
Transtorno da Personalidade Compulsiva/terapia , Transtorno Obsessivo-Compulsivo/terapia , Índice de Gravidade de Doença , Adulto , Comportamento Compulsivo/psicologia , Transtorno da Personalidade Compulsiva/psicologia , Feminino , Humanos , Transtorno Obsessivo-Compulsivo/psicologia , Resultado do Tratamento
16.
Rev Endocr Metab Disord ; 20(3): 263-272, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31654260

RESUMO

Impulsivity and compulsivity are multidimensional constructs that are increasingly considered determinants of obesity. Studies using functional magnetic resonance imaging (fMRI) have provided insight on how differences in brain response during tasks exploring facets of impulsivity and compulsivity relate to the ingestive behaviors that support the etiology and maintenance of obesity. In this narrative review, we provide an overview of neuroimaging studies exploring impulsivity and compulsivity factors as they relate to weight status. Special focus will be placed on studies examining the impulsivity-related dimensions of attentional bias, delayed gratification and emotion regulation. Discussions of compulsivity within the context of obesity will be restricted to fMRI studies investigating habit formation and response flexibility under shifting contingencies. Further, we will highlight neuroimaging research demonstrating how alterations in neuroendocrine functioning are linked to excessive food intake and may serve as a driver of the impulsive and compulsive behaviors observed in obesity. Research on the associations between brain response with neuroendocrine factors, such as insulin, peptide YY (PYY), leptin, ghrelin and glucagon-like peptide 1 (GLP-1), will be reviewed.


Assuntos
Comportamento Compulsivo/patologia , Imagem por Ressonância Magnética/métodos , Obesidade/patologia , Animais , Humanos , Neuroimagem/métodos
17.
Transl Psychiatry ; 9(1): 222, 2019 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-31501410

RESUMO

BTB/POZ domain-containing 3 (BTBD3) was identified as a potential risk gene in the first genome-wide association study of obsessive-compulsive disorder (OCD). BTBD3 is a putative transcription factor implicated in dendritic pruning in developing primary sensory cortices. We assessed whether BTBD3 also regulates neural circuit formation within limbic cortico-striato-thalamo-cortical circuits and behaviors related to OCD in mice. Behavioral phenotypes associated with OCD that are measurable in animals include compulsive-like behaviors and reduced exploration. We tested Btbd3 wild-type, heterozygous, and knockout mice for compulsive-like behaviors including cage-mate barbering, excessive wheel-running, repetitive locomotor patterns, and reduced goal-directed behavior in the probabilistic learning task (PLT), and for exploratory behavior in the open field, digging, and marble-burying tests. Btbd3 heterozygous and knockout mice showed excessive barbering, wheel-running, impaired goal-directed behavior in the PLT, and reduced exploration. Further, chronic treatment with fluoxetine, but not desipramine, reduced barbering in Btbd3 wild-type and heterozygous, but not knockout mice. In contrast, Btbd3 expression did not alter anxiety-like, depression-like, or sensorimotor behaviors. We also quantified dendritic morphology within anterior cingulate cortex, mediodorsal thalamus, and hippocampus, regions of high Btbd3 expression. Surprisingly, Btbd3 knockout mice only showed modest increases in spine density in the anterior cingulate, while dendritic morphology was unaltered elsewhere. Finally, we virally knocked down Btbd3 expression in whole, or just dorsal, hippocampus during neonatal development and assessed behavior during adulthood. Whole, but not dorsal, hippocampal Btbd3 knockdown recapitulated Btbd3 knockout phenotypes. Our findings reveal that hippocampal Btbd3 expression selectively modulates compulsive-like and exploratory behavior.


Assuntos
Encéfalo/metabolismo , Comportamento Compulsivo/metabolismo , Comportamento Exploratório/fisiologia , Rede Nervosa/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Animais , Antidepressivos/farmacologia , Antidepressivos/uso terapêutico , Comportamento Animal/efeitos dos fármacos , Comportamento Animal/fisiologia , Comportamento Compulsivo/tratamento farmacológico , Comportamento Compulsivo/genética , Desipramina/farmacologia , Desipramina/uso terapêutico , Modelos Animais de Doenças , Comportamento Exploratório/efeitos dos fármacos , Fluoxetina/farmacologia , Fluoxetina/uso terapêutico , Camundongos , Camundongos Knockout , Atividade Motora/efeitos dos fármacos , Atividade Motora/fisiologia , Proteínas do Tecido Nervoso/genética , Transtorno Obsessivo-Compulsivo/genética , Transtorno Obsessivo-Compulsivo/metabolismo
18.
Transl Psychiatry ; 9(1): 225, 2019 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-31515486

RESUMO

Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder with childhood onset, and is characterized by intrusive thoughts and fears (obsessions) that lead to repetitive behaviors (compulsions). Previously, we identified insulin signaling being associated with OCD and here, we aim to further investigate this link in vivo. We studied TALLYHO/JngJ (TH) mice, a model of type 2 diabetes mellitus, to (1) assess compulsive and anxious behaviors, (2) determine neuro-metabolite levels by 1 H magnetic resonance spectroscopy (MRS) and brain structural connectivity by diffusion tensor imaging (DTI), and (3) investigate plasma and brain protein levels for molecules previously associated with OCD (insulin, Igf1, Kcnq1, and Bdnf) in these subjects. TH mice showed increased compulsivity-like behavior (reduced spontaneous alternation in the Y-maze) and more anxiety (less time spent in the open arms of the elevated plus maze). In parallel, their brains differed in the white matter microstructure measures fractional anisotropy (FA) and mean diffusivity (MD) in the midline corpus callosum (increased FA and decreased MD), in myelinated fibers of the dorsomedial striatum (decreased FA and MD), and superior cerebellar peduncles (decreased FA and MD). MRS revealed increased glucose levels in the dorsomedial striatum and increased glutathione levels in the anterior cingulate cortex in the TH mice relative to their controls. Igf1 expression was reduced in the cerebellum of TH mice but increased in the plasma. In conclusion, our data indicates a role of (abnormal) insulin signaling in compulsivity-like behavior.


Assuntos
Encéfalo/metabolismo , Comportamento Compulsivo/metabolismo , Insulina/metabolismo , Transdução de Sinais/fisiologia , Animais , Ansiedade/diagnóstico por imagem , Ansiedade/metabolismo , Glicemia , Encéfalo/diagnóstico por imagem , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Comportamento Compulsivo/diagnóstico por imagem , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Diabetes Mellitus Tipo 2/metabolismo , Imagem de Tensor de Difusão , Modelos Animais de Doenças , Fator de Crescimento Insulin-Like I/metabolismo , Canal de Potássio KCNQ1/metabolismo , Espectroscopia de Ressonância Magnética , Camundongos , Proteômica , Substância Branca/diagnóstico por imagem
19.
J Behav Addict ; 8(3): 530-536, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31505967

RESUMO

BACKGROUND: Compulsive Internet use (CIU) refers to those individuals who experience a loss of control regarding their online use. Although suffered by a minority, a much larger proportion of adults report to be experiencing early signs of CIU, which can become more problematic if sustained over time, especially when used as a coping mechanism for stress. Since compulsive behaviors are characterized by executing behaviors on "automatic pilot," mindfulness techniques, which help individuals relate more consciously with their environment, could help develop a more adaptive relationship with technology. However, mindfulness interventions are often lengthy hence not ideal for busy individuals with early signs of CIU. AIMS: This study tested the effectiveness of a brief mindfulness intervention (10 min a day for 2 weeks) to reduce CIU and anxiety and depression symptoms, in relation to an equivalent length classic arousal descending technique (i.e., gradual-muscle-relaxation), and a wait-list control group. METHODS: A randomized controlled trial (RCT) was used with assessments at pre- and post-phases. Participants showing initial signs of CIU were allocated to a mindfulness-group (n = 343), gradual-relaxation (n = 301), or a wait-list control group (n = 350). RESULTS: The mindfulness and gradual-muscle-relaxation participants were equally effective in reducing anxiety and depression. The mindfulness intervention was more effective reducing CIU symptoms. DISCUSSION: Given the large sample sizes of this RCT, these results are promising, although follow-up studies are needed. Considering health hazards of the "always-on-culture" and the popularity of bite-sized learning, the effectiveness of easy-to fit-in daily life health practices is a positive development.


Assuntos
Ansiedade/terapia , Comportamento Compulsivo/terapia , Depressão/terapia , Internet , Atenção Plena/métodos , Relaxamento Muscular , Terapia de Relaxamento/métodos , Adulto , Feminino , Humanos , Masculino , Resultado do Tratamento
20.
J Behav Addict ; 8(3): 442-450, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31505968

RESUMO

BACKGROUND AND AIMS: Cybersex is increasingly associated with concerns about compulsive use. The aim of this study was to assess the roles of motives and sexual desire in the compulsive use of cybersex. METHODS: The sample consisted of 306 cybersex users (150 men and 156 women). The participants were assessed using the Compulsive Internet Use Scale (CIUS) adapted for cybersex, the Cybersex Motives Questionnaire (enhancement, coping, and social motives), and the Sexual Desire Inventory-2 (dyadic and solitary sexual desire). RESULTS: For both genders, coping motive was associated with CIUS score. For women, an additional association with social motives was found whereas an association with sexual desire was found for men. CONCLUSION: The study showed gender differences in the contributors to sex-related CIUS scores.


Assuntos
Adaptação Psicológica/fisiologia , Comportamento Compulsivo/fisiopatologia , Literatura Erótica , Internet , Motivação/fisiologia , Comportamento Sexual/fisiologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA