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1.
Health Qual Life Outcomes ; 18(1): 204, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590995

RESUMO

BACKGROUND: An important question influencing therapy for dizziness is whether the strengths of the relationships of emotional and functional aspects of dizziness to 1) anxiety and other mental states, 2) perceived state of health (SoH) and quality of life (QoL) are different in patients with and without normal balance control. We attempted to answer this question by examining these dimensions' regression strengths with Dizziness Handicap Inventory (DHI) scores. METHODS: We divided 40 patients receiving group cognitive behavioural therapy (CBT) and vestibular rehabilitation for dizziness, into 2 groups: dizziness only (DO) and normal balance control; dizziness and a quantified balance deficit (QBD). Group-wise, we first performed stepwise multivariate regression analysis relating total DHI scores with Brief Symptom Inventory (BSI) sub-scores obtained pre- and post-therapy. Then, regression analysis was expanded to include SoH, QoL, and balance scores. Finally, we performed regressions with DHI sub-scores. RESULTS: In both groups, the BSI phobic anxiety state score was selected first in the multivariate regression analysis. In the DO group, obsessiveness/compulsiveness was also selected. The correlation coefficient, R, was 0.74 and 0.55 for the DO and QBD groups, respectively. When QoL and SoH scores were included, R values increased to 0.86 and 0.74, explaining in total 74, and 55% of the DHI variance for DO and QBD groups, respectively. Correlations with balance scores were not significant (R ≤ 0.21). The psychometric scores selected showed the strongest correlations with emotional DHI sub-scores, and perceived QoL and SoH scores with functional DHI sub-scores. CONCLUSIONS: Our findings suggest that reducing phobic anxiety and obsessiveness/compulsiveness during CBT may improve emotional aspects of dizziness and targeting perceived SoH and QoL may improve functional aspects of dizziness for those with and without normal balance control.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Tontura/terapia , Terapia por Exercício/métodos , Qualidade de Vida , Adulto , Idoso , Ansiedade/complicações , Estudos de Casos e Controles , Tontura/complicações , Tontura/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/complicações , Equilíbrio Postural/fisiologia
2.
PLoS One ; 15(6): e0234724, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32544176

RESUMO

The major symptoms of Tourette syndrome are motor and vocal tics, but Tourette syndrome is occasionally associated with cognitive alterations as well. Although Tourette syndrome does not affect the majority of cognitive functions, some of them improve. There is scarce evidence on the impairment of learning functions in patients with Tourette syndrome. The core symptoms of Tourette syndrome are related to dysfunction of the basal ganglia and the frontostriatal loops. Acquired equivalence learning is a kind of associative learning that is related to the basal ganglia and the hippocampi. The modified Rutgers Acquired Equivalence Test was used in the present study to observe the associative learning function of patients with Tourette syndrome. The cognitive learning task can be divided into two main phases: the acquisition and test phases. The latter is further divided into two parts: retrieval and generalization. The acquisition phase of the associative learning test, which mainly depends on the function of the basal ganglia, was affected in the entire patient group, which included patients with Tourette syndrome with attention deficit hyperactivity disorder, obsessive compulsive disorder, autism spectrum disorder, or no comorbidities. Patients with Tourette syndrome performed worse in building associations. However, the retrieval and generalization parts of the test phase, which primarily depend on the function of the hippocampus, were not worsened by Tourette syndrome.


Assuntos
Testes Neuropsicológicos , Síndrome de Tourette/diagnóstico , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Espectro Autista/complicações , Gânglios da Base/fisiologia , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/complicações , Síndrome de Tourette/complicações
3.
Complement Ther Clin Pract ; 39: 101098, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32379640

RESUMO

BACKGROUND AND PURPOSE: Parents of children with obsessive-compulsive disorder (OCD) report significant emotional and socio-occupational impacts. There is, however, currently insufficient support for these parents. This study examined a mindfulness-based intervention for parents of OCD-affected children, investigating its feasibility and impact on parental ability to tolerate their child's OCD-related distress, in addition to exploring potential indirect effects. MATERIALS AND METHODS: Parents of OCD-affected children (n = 39) completed an eight-week baseline observation period followed by eight, weekly manualized mindfulness-based intervention group sessions. Measures of parental tolerance of child distress, dispositional mindfulness, family accommodation, family functioning, and OCD symptom severity were collected. RESULTS: In comparison to the baseline observation period, parental tolerance of child distress and dispositional mindfulness significantly improved following mindfulness training. No other temporal differences were observed. Parents reported high satisfaction. CONCLUSION: Mindfulness-based skills training for parents of OCD-affected youth appears to be feasible and to significantly increase tolerance related to the child's distress. CLINICAL TRIAL REGISTRATION NUMBER: NCT03212703.


Assuntos
Adaptação Psicológica , Cuidadores/psicologia , Atenção Plena , Transtornos do Neurodesenvolvimento , Transtorno Obsessivo-Compulsivo , Pais/psicologia , Angústia Psicológica , Adolescente , Adulto , Idoso , Criança , Emoções , Família/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Neurodesenvolvimento/complicações , Transtorno Obsessivo-Compulsivo/complicações , Resiliência Psicológica , Adulto Jovem
4.
Fortschr Neurol Psychiatr ; 88(6): 398-401, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32380556

RESUMO

Die Zwangsstörung hat oftmals einen chronischen Verlauf mit Therapieresistenz gegenüber Psychopharmakotherapie und Psychotherapie. Neue nichtinvasive Hirnstimulationsverfahren könnten helfen, Zwangssymptome zu vermindern. In diesem Fallbericht wird die Behandlung einer Patientin mit Zwangsstörung dargestellt, die mit 10 transkraniellen Wechselstromstimulationen in Gamma-Frequenz (40 Hz) im Rahmen eines Heilversuchs behandelt wurde. Die Yale-Brown Obsessive-Compulsive Scale verminderte sich von 70 auf 59 Punkte, und die Hamilton Depression Rating Scale sank von 25 auf 12 Punkte. Daneben konnte eine Verbesserung des Regensburger Wortflüssigkeitstests, des Pfadfindertests und eines computergestützten n-back-Tests verzeichnet werden. Eine Hypothese für die Verbesserung der Zwangsstörung durch Gamma-Wechselstromstimulation könnte eine Auswirkung auf die bei psychischen Erkrankungen (Depression, Zwangsstörung) veränderte alpha-Frequenz sein. Der hier vorgestellte Fall bestätigt die Ergebnisse einer früheren Fallserie und gibt Anlass zur weiteren Untersuchung dieses Verfahrens.


Assuntos
Ritmo Gama , Transtorno Obsessivo-Compulsivo/fisiopatologia , Transtorno Obsessivo-Compulsivo/terapia , Ritmo alfa , Depressão/complicações , Depressão/fisiopatologia , Depressão/psicologia , Depressão/terapia , Humanos , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/psicologia
5.
Brain Stimul ; 13(3): 858-860, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32289717

RESUMO

Transcranial direct current stimulation (tDCS) is a type of non-invasive brain stimulation technique that is explored as an add-on treatment for the alleviation of symptoms across the diverse symptom domains in neuropsychiatric disorders. In psychiatry, data is emerging on the effects of tDCS as an add-on treatment in schizophrenia as well as obsessive-compulsive disorder (OCD). But despite high prevalence, the effectiveness of tDCS in co-morbid schizophrenia and OCD is lacking. This case report for the first time examines the clinical utility with target-specific effects of the add-on tDCS in a patient diagnosed with schizo-obsessive disorder.


Assuntos
Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/terapia , Esquizofrenia/diagnóstico , Esquizofrenia/terapia , Estimulação Transcraniana por Corrente Contínua/métodos , Comorbidade , Feminino , Humanos , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/complicações , Esquizofrenia/complicações , Resultado do Tratamento
6.
PLoS One ; 15(4): e0231390, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294104

RESUMO

OBJECTIVE: Analyze a large sample with detailed clinical data of misophonia subjects in order to determine the psychiatric, somatic and psychological nature of the condition. METHODS: This observational study of 779 subjects with suspected misophonia was conducted from January 2013 to May 2017 at the outpatient-clinic of the Amsterdam University Medical Centers, location AMC, the Netherlands. We examined DSM-IV diagnoses, results of somatic examination (general screening and hearing tests), and 17 psychological questionnaires (e.g., SCL-90-R, WHOQoL). RESULTS: The diagnosis of misophonia was confirmed in 575 of 779 referred subjects (74%). In the sample of misophonia subjects (mean age, 34.17 [SD = 12.22] years; 399 women [69%]), 148 (26%) subjects had comorbid traits of obsessive-compulsive personality disorder, 58 (10%) mood disorders, 31 (5%) attention-deficit (hyperactivity) disorder, and 14 (3%) autism spectrum conditions. Two percent reported tinnitus and 1% hyperacusis. In a random subgroup of 109 subjects we performed audiometry, and found unilateral hearing loss in 3 of them (3%). Clinical neurological examination and additional blood test showed no abnormalities. Psychological tests revealed perfectionism (97% CPQ>25) and neuroticism (stanine 7 NEO-PI-R). Quality of life was heavily impaired and associated with misophonia severity (rs (184) = -.34 p = < .001, p = < .001). LIMITATIONS: This was a single site study, leading to possible selection-and confirmation bias, since AMC-criteria were used. CONCLUSIONS: This study with 575 subjects is the largest misophonia sample ever described. Based on these results we propose a set of revised criteria useful to diagnose misophonia as a psychiatric disorder.


Assuntos
Comportamento Impulsivo , Transtornos Mentais/diagnóstico , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/patologia , Transtorno Autístico/complicações , Transtorno Autístico/patologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Transtornos Mentais/complicações , Transtornos Mentais/patologia , Pessoa de Meia-Idade , Transtornos do Humor/complicações , Transtornos do Humor/patologia , Países Baixos , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/patologia , Índice de Gravidade de Doença , Adulto Jovem
7.
Ann Acad Med Singap ; 49(1): 15-25, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32200393

RESUMO

INTRODUCTION: Using data from Singapore Mental Health Study 2016 (SMHS 2016), we examined the prevalence of lifetime and 12-month obsessive-compulsive disorder (OCD), its sociodemographic correlates and association with comorbid psychiatric disorders and physical conditions, perceived social support and quality of life. MATERIALS AND METHODS: The World Mental Health Composite International Diagnostic Interview (version 3.0) was administered by trained interviewers to 6126 residents aged ≥18 years old to assess OCD prevalence and that of other select psychiatric disorders. Details on sociodemographics, perceived social support and health-related quality of life were obtained. RESULTS: Lifetime and 12-month prevalence of OCD was 3.6% and 2.9%, respectively. Adjusted regression analysis showed that those with OCD had significantly higher odds of major depressive disorder (odds ratio [OR], 5.4), bipolar disorder (OR, 8.9), generalised anxiety disorder (OR, 7.3) and alcohol abuse (OR, 2.7). OCD was significantly associated with suicidal ideation and suicidality (OR, 5.1). OCD subjects also had higher odds of chronic pain (OR, 2.4) and diabetes (OR, 3.1). Finally, OCD subjects had lower mean mental composite summary scores than controls (respondents without any of the psychiatric disorders and physical conditions included in SMHS 2016) and those with other lifetime psychiatric disorders and physical conditions. CONCLUSION: OCD prevalence in Singapore is high. Most people with OCD do not seek treatment despite experiencing significant comorbidity and loss of quality of life.


Assuntos
Transtorno Depressivo Maior , Transtorno Obsessivo-Compulsivo , Aceitação pelo Paciente de Cuidados de Saúde , Qualidade de Vida , Adolescente , Adulto , Comorbidade , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/terapia , Razão de Chances , Singapura/epidemiologia , Apoio Social , Ideação Suicida
8.
BMC Psychiatry ; 20(1): 36, 2020 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-32000754

RESUMO

BACKGROUND: Obsessive-compulsive disorder (OCD) is common in patients with eating disorders (EDs). There is a lack of research investigating the presence of ED symptoms among patients with OCD, despite concerns that many of these patients may be at high risk for EDs. Our objective was to assess the presence of ED symptoms in patients receiving treatment for OCD. METHODS: Adult patients with OCD (n = 132, 71% females) and controls (n = 260, 90% females) completed the Eating Disorder Examination-Questionnaire (EDE-Q) at admission to a specialized OCD outpatient unit. A small subset of patients (n = 22) also completed the EDE-Q 3-months after end of treatment. RESULTS: At the group-level, mean EDE-Q scores did not differ significantly between female patients and controls. However, female patients compared to controls were significantly more likely to score above the EDE-Q cut-off (23% vs. 11%) and have a probable ED (9% vs. 1%), indicating elevated rates of ED symptoms in the clinical range. There was no evidence of elevated rates of ED symptoms in male patients, though sample sizes were small. Preliminary follow-up data showed that certain ED symptoms improved significantly from admission to 3-month follow-up. CONCLUSIONS: Our findings suggest that while ED symptoms are not generally elevated in female patients with OCD, a considerable subset of female patients may have a clinical ED or be at high risk of developing one. Clinicians should be alert to ED symptoms in female patients with OCD, and our findings raise the issue of whether ED screening of female patients with OCD is warranted.


Assuntos
Anorexia Nervosa , Transtornos da Alimentação e da Ingestão de Alimentos , Transtorno Obsessivo-Compulsivo , Adulto , Anorexia Nervosa/epidemiologia , Comorbidade , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Feminino , Hospitalização , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia
9.
J Altern Complement Med ; 26(5): 398-408, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32073874

RESUMO

Objective: The present study was conducted to investigate the effect of Viola odorata extracted syrup on the quality and patterns of sleep in patients with depression or obsessive-compulsive disorder (OCD) as add-on therapy. Design: A pilot double-blind randomized placebo-controlled trial. Settings/Location: Psychiatric Clinic of Imam Hossein Hospital, Tehran, Iran. Subjects: Participants were 16-15 years of age with mild and moderate depression or OCD having insomnia. Interventions: This pilot study was conducted on patients with insomnia divided into two groups with depression (40 patients) or OCD (43 patients). Each group randomly assigned into two arms with the same conditions at baseline. The intervention arm daily received 5 mL V. odorata syrup every 12 h for 4 weeks, and the control arm received 5 mL placebo syrup every 12 h for 4 weeks. None of the participants was deprived of their routine treatment for depression or OCD. Outcome measures: The scores of insomnia symptoms were evaluated using total score of the Pittsburgh Sleep Quality Index (PSQI) and the scores of its components, the depression score using the final Beck depression inventory-II (BDI-II) score, and OCD score using the Yale-Brown Obsessive-Compulsive Scale (YBOCS). Results: The total PSQI score was found to be improved significantly in the intervention arms with depression or OCD (p < 0.001) compared with the corresponding control arms. Significant improvements were also observed in the final mean difference of BDI-II (p = 0.009) and YBOCS (p = 0.001) scores in the intervention arms. Conclusions: V. odorata syrup significantly improved insomnia symptoms and the scores of depression and OCD.


Assuntos
Transtorno Depressivo/tratamento farmacológico , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Preparações de Plantas/uso terapêutico , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Viola , Adolescente , Adulto , Transtorno Depressivo/complicações , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/complicações , Projetos Piloto , Distúrbios do Início e da Manutenção do Sono/etiologia , Inquéritos e Questionários , Adulto Jovem
10.
Neuropsychiatr ; 34(1): 27-29, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31828741

RESUMO

Obsessive-compulsive disorder (OCD) is characterized by repetitive, persistent and unwanted thoughts and ritualistic, repetitive behaviors. The pathophysiology of OCD involves many distinct cortical and subcortical regions and it has been reported that OCD may occur as a consequence of traumatic brain injury, infections and tumors as well as cerebrovascular insult such as cerebral venous sinus thrombosis (CVST). We here describe the case of a 36-year-old woman who developed OCD at the age of 13 with almost complete remission of the symptoms after a 1 year-long treatment. Interestingly, after suffering CVST at the superior sagittal sinus at the age of 33, she experienced a relapse of OCD. The patient was successfully treated with Sertraline and Clomipramine. Previous studies revealed cases of OCD following different cerebrovascular accidents, i.e. predominantly arterial stroke. However, the present case is the first to describe OCD after venous thrombosis. Based on our clinical experience, the most effective treatment of OCD after CVST represents the combination of the selective serotonin reuptake inhibitor Sertraline and the tricyclic antidepressant Clomipramine.


Assuntos
Transtorno Obsessivo-Compulsivo/complicações , Trombose dos Seios Intracranianos/complicações , Adolescente , Adulto , Clomipramina/uso terapêutico , Feminino , Humanos , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Recidiva , Sertralina/uso terapêutico
11.
BMJ Case Rep ; 12(11)2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31780608

RESUMO

Schizophrenia likely represents a cluster of diseases presenting with delusions, hallucinations, disorganised behaviour and disorganised thought. Currently, medical therapy struggles to treat a substantial portion of patients, but with improved stratification of component diseases, it may be possible to better understand and treat schizophrenia. The overlap between schizophrenia, schizo-obsessive disorder and obsessive-compulsive disorder is discussed within the context of a clinical case and neuroimaging data. Furthermore, the use of obsessive-compulsive disorder deep brain stimulation protocols for schizo-obsessive disorder is discussed and may yield an advance in neurosurgical treatment of psychiatric conditions.


Assuntos
Transtorno Obsessivo-Compulsivo/complicações , Esquizofrenia/complicações , Esquizofrenia/cirurgia , Adulto , Humanos , Masculino , Procedimentos Neurocirúrgicos
12.
Psychiatr Danub ; 31(Suppl 3): 376-380, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488755

RESUMO

BACKGROUND: Mobius syndrome is characterized by a bilateral congenital paralysis of the facial and abducens nerves which leaves the subject with an expressionless "mask-like" face. SUBJECTS AND METHODS: Based on a literature review and a case discussion of an adult patient with Mobius syndrome and obsessive-compulsive disorder, initially undiagnosed and confused with a psychotic disorder, we will discuss the influence of Mobius syndrome in psychiatric evaluations. RESULTS: The lack of facial expressiveness and non-verbal emotional interactions may influence psychiatric evaluations and result in misdiagnosis and the inappropriate prescribing of antipsychotics. In the case analysis, we also observed other associated malformations such as renal atrophy, a bicuspid aortic valve and mitral valve prolapse. CONCLUSION: We feel that educating the patient about the communicative consequences of impaired facial expressions and facial interactions is a necessary prerequisite for any psychiatric or psychological evaluation in subjects with Mobius syndrome. We also recommend using caution when prescribing antipsychotics in patients with Mobius syndrome given the motor side effects secondary to a potentially pre-existing hypotonia.


Assuntos
Erros de Diagnóstico , Síndrome de Möbius/complicações , Síndrome de Möbius/diagnóstico , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/diagnóstico , Adulto , Antipsicóticos/uso terapêutico , Expressão Facial , Humanos , Síndrome de Möbius/tratamento farmacológico , Síndrome de Möbius/patologia , Comunicação não Verbal , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Transtorno Obsessivo-Compulsivo/patologia
13.
Riv Psichiatr ; 54(4): 168-174, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31379382

RESUMO

OBJECTIVE: The primary objective of this study was to compare the adult-onset and adolescent obsessive-compulsive disorder (OCD) patients in terms of the subthreshold autistic traits. METHODS: 29 adolescent, and 45 adult-onset OCD patients were assessed by Autism-spectrum Quotient (AQ). RESULTS: The ratio of males to females, the frequency of ritualistic compulsions, and the mean number of lifetime compulsions were significantly higher in adolescents with OCD compared to adult-onset patients. Adult-onset OCD patients had significantly higher scores on total, social skills, attention shifting, and imagination subscales of AQ than adolescent OCD patients. The mean number of compulsions, attention shifting scores of AQ, and female gender significantly predicted the distinction between adolescent and adult-onset OCD patients. In adult-onset patients, there were significant correlations between the mean number of lifetime obsessions and total, social skills, attention switching, communication, and imagination subscale scores of AQ. CONCLUSIONS: We suggest that subthreshold autistic traits may play a significant role in the occurence of obsessive-complusive symptoms (OCS) in adult-onset OCD. Autistic traits seemed to be higher and had an closer relationship with the frequency of lifetime obsessions in AO-OCD patients than in adolescent patients.


Assuntos
Transtorno Autístico/psicologia , Comportamento Obsessivo , Transtorno Obsessivo-Compulsivo/psicologia , Adolescente , Adulto , Fatores Etários , Idade de Início , Transtorno Autístico/complicações , Feminino , Humanos , Masculino , Análise Multivariada , Transtorno Obsessivo-Compulsivo/complicações , Fatores Sexuais , Avaliação de Sintomas
15.
Curr Psychiatry Rep ; 21(8): 64, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31263973

RESUMO

PURPOSE OF REVIEW: This review will aim to summarize the current body of epidemiological, clinical and therapeutic knowledge concerning specific co-occurrence of obsessive-compulsive symptoms (OCSs) and schizophrenia spectrum disorder. RECENT FINDINGS: Almost 30% of the patients with schizophrenia display OCS, and three main contexts of emergence are identified: prodromal symptoms of schizophrenia, co-occurrence of OCS and schizophrenia and antipsychotics-induced OCS. Recent clinical studies show that patients with SZ and OCS have more severe psychotic and depressive symptoms, higher suicidality and lower social functioning. A recent cognitive investigation found that OCS and delusions share specific metacognitive profiles, particularly through a heightened need to control thoughts. Finally, a recent cross-sectional study of clozapine-induced OCS found a dose-response relationship between clozapine and OCS. OCS appeared reliably as linked to poorer outcomes among patients with schizophrenia. However, the specific clinical value of OCS among other prodromal symptoms of schizophrenia remains unknown.


Assuntos
Transtorno Obsessivo-Compulsivo/complicações , Esquizofrenia/complicações , Antipsicóticos/administração & dosagem , Antipsicóticos/efeitos adversos , Antipsicóticos/uso terapêutico , Clozapina/administração & dosagem , Clozapina/efeitos adversos , Clozapina/uso terapêutico , Estudos Transversais , Humanos , Transtorno Obsessivo-Compulsivo/induzido quimicamente , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Transtorno Obsessivo-Compulsivo/epidemiologia , Sintomas Prodrômicos , Esquizofrenia/tratamento farmacológico , Esquizofrenia/epidemiologia
16.
Expert Opin Drug Metab Toxicol ; 15(8): 619-631, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31271537

RESUMO

Introduction: The comorbidity between obsessive-compulsive disorder (OCD) and bipolar disorders (BDs) is a frequent and severe condition characterized by a chronic course, high suicidal risk and tendency towards chronicity and treatment non-response. It represents a real challenge to psychiatrists, while requiring a careful and appropriate therapeutic management consisting in the combination of serotonergic antidepressants (ADs), such as serotonin reuptake inhibitors (SRIs), with mood stabilizers. This combination, like any other, raises the problems related to drug interactions that may lead to pharmacokinetic and pharmacodynamic changes, resulting in the modification of the pharmacologic effect and safety profile of a given compound. Areas covered: The aim of the present paper was to review the literature on the pharmacokinetic and pharmacodynamic changes resulting from the interactions of the different drugs prescribed in the OCD-BD comorbidity. Expert opinion: The literature data on pharmacokinetic and pharmacodynamic changes due to interactions of drugs commonly prescribed in the treatment of the OCD-BD comorbidity are extremely limited, and the information is inferred by findings gathered in psychiatric patients suffering from other disorders. This represents a gap in psychopharmacology that should be filled by specific studies on this important topic.


Assuntos
Transtorno Bipolar/tratamento farmacológico , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Antimaníacos/administração & dosagem , Antimaníacos/farmacocinética , Antimaníacos/farmacologia , Antipsicóticos/administração & dosagem , Antipsicóticos/farmacocinética , Antipsicóticos/farmacologia , Transtorno Bipolar/complicações , Interações Medicamentosas , Humanos , Transtorno Obsessivo-Compulsivo/complicações , Inibidores de Captação de Serotonina/administração & dosagem , Inibidores de Captação de Serotonina/farmacocinética , Inibidores de Captação de Serotonina/farmacologia
17.
Eat Behav ; 34: 101298, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31176948

RESUMO

Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) are highly comorbid. However, little research has examined which specific cognitive-behavioral aspects (e.g., checking, obsessing) of OCD are most relevant in those with AN. Furthermore, there is no research examining aspects of OCD in Atypical AN. The current two studies (N = 139 and N = 115 individuals diagnosed with AN/Atypical AN) examined a) which aspects of OCD were most related to AN symptomatology and b) if there were differences in OCD between individuals diagnosed with AN vs Atypical AN. We found that obsessing was most related to AN symptoms. We also found that there were no substantial significant differences between AN and Atypical AN. These findings add to the literature suggesting minimal differences between AN and Atypical AN, specifically regarding OCD symptomatology. These findings clarify that obsessions (rather than compulsions) may be the specific aspect of OCD most warranting treatment intervention in AN and Atypical AN.


Assuntos
Anorexia Nervosa/psicologia , Comportamento Obsessivo/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Adolescente , Adulto , Anorexia Nervosa/complicações , Anorexia Nervosa/diagnóstico , Comorbidade , Comportamento Compulsivo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/diagnóstico , Escalas de Graduação Psiquiátrica , Psicometria , Adulto Jovem
18.
Rev. Hosp. Ital. B. Aires (2004) ; 39(2): 64-66, jun. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1048015

RESUMO

El trastorno obsesivo-compulsivo (TOC) afecta al 2% de la población general, llegando en ocasiones a causar un deterioro funcional severo y de la calidad de vida de las personas afectadas. Entre el 10 y el 30% de los pacientes con este trastorno no responde a los tratamientos recomendados: farmacológicos y terapia cognitivo-conductual. La Food and Drug Administration de los Estados Unidos (FDA) aprobó en el año 2008 la Estimulación cerebral profunda (ECP) para pacientes con TOC resistente a tratamiento. La ECP, utilizada frecuentemente para el tratamiento de la enfermedad de Parkinson refractaria, es una opción viable para los pacientes con TOC resistente, con efectos adversos poco frecuentes y transitorios. (AU)


Obsessive-compulsive disorder (OCD) affects 2% of the general population, sometimes resulting in severe impairment of functional capacity and quality of life of affected people. Between 10 and 30% of these patients do not respond to recommended treatments: pharmacological and cognitive behavioral therapy. In 2008, the FDA approved Deep Brain Stimulation (DBS) for patients with OCD resistant to treatment. DBS, frequently used for the treatment of refractory Parkinson's disease, is a viable option for the treatment of patients with resistant OCD, with infrequent and transient adverse effects. (AU)


Assuntos
Humanos , Estimulação Encefálica Profunda/métodos , Transtorno Obsessivo-Compulsivo/terapia , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Qualidade de Vida , Sinais e Sintomas , Estimulação Encefálica Profunda/efeitos adversos , Estimulação Encefálica Profunda/tendências , Transtornos Mentais/cirurgia , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/etiologia , Transtorno Obsessivo-Compulsivo/tratamento farmacológico
19.
J Autism Dev Disord ; 49(9): 3602-3610, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31134428

RESUMO

Family accommodation occurs frequently among families of children with OCD and anxiety disorders, with higher levels of accommodation repeatedly associated with greater symptom severity, lower functioning, and poorer treatment outcomes for children. This is the first examination of family accommodation of restricted and repetitive behaviors (RRBs) in children with autism spectrum disorder (ASD). Parents of children with ASD (N = 86) completed questionnaires assessing their children's RRBs and parental accommodation of these symptoms. Most participants (80%) reported engaging in accommodation at least once a month and family accommodation was significantly positively correlated with RRB severity. These results suggest accommodation of RRBs follows a pattern similar to that reported in obsessive compulsive and anxiety disorders, and highlight avenues for potential parent-based interventions.


Assuntos
Transtornos de Ansiedade/psicologia , Transtorno do Espectro Autista/psicologia , Família/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Adaptação Psicológica , Adolescente , Transtornos de Ansiedade/complicações , Atitude , Transtorno do Espectro Autista/complicações , Criança , Relações Familiares , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/complicações , Inquéritos e Questionários
20.
Psychiatr Q ; 90(3): 491-505, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31098922

RESUMO

Cyberchondria denotes repeated online searches for health information that are associated with increasing levels of health anxiety. The aims of this study were to apply network analysis to investigate the extent to which cyberchondria is a distinct construct, ascertain which of the related constructs have the strongest relationships with cyberchondria and investigate whether some of the symptoms of cyberchondria are more central to the construct of cyberchondria. Questionnaires assessing the severity of cyberchondria, health anxiety, obsessive-compulsive disorder symptoms, intolerance of uncertainty, problematic Internet use, anxiety, depression and somatic symptoms were administered to 751 participants who searched for health information online during a previous 3-month period and were recruited from an online crowdsourcing platform. Network analyses were used to compute the networks, perform community detection tests and calculate centrality indices. Results suggest that cyberchondria is a relatively specific syndrome-like construct, distinct from all related constructs and consisting of interrelated symptoms. It has the strongest relationships with problematic Internet use and health anxiety. No symptom of cyberchondria emerged clearly as more central to the construct of cyberchondria. Future research should aim to deepen our understanding of cyberchondria and its links with psychopathology, especially its close relationship with problematic Internet use.


Assuntos
Ansiedade/psicologia , Informação de Saúde ao Consumidor , Hipocondríase/psicologia , Internet , Ansiedade/complicações , Comportamento Aditivo/psicologia , Análise por Conglomerados , Depressão/complicações , Depressão/psicologia , Humanos , Hipocondríase/complicações , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/psicologia , Inquéritos e Questionários , Incerteza
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