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1.
Acta Neurol Scand ; 140(6): 390-398, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31418815

RESUMO

OBJECTIVE: The aim of this study is to gain more insight in the differential contributions of anxiety, depression and obsessive-compulsive (OC) symptom severity to quality of life (QoL) and tic severity in adults with Tourette Disorder (TD). METHODS: Self-reported OC symptom, anxiety and depression severity measures were used to investigate their predictive value on QoL and Tic severity in adult TD patients (N = 187), using correlation, regression, and mediation analyses. RESULTS: Tic severity has no effect on QoL. Depression severity directly reduces QoL, whereas anxiety and OC symptom severity have an indirect effect on QoL, mediated by depression severity. OC symptom severity directly affects tic severity, whereas depression and anxiety severity do not have a direct effect on tic or OC severity. Finally, anxiety severity indirectly impacts tic severity, with OC symptom severity functioning as a mediator. CONCLUSION: In line with and extending previous studies, these findings indicate that OC symptom severity directly influences tic symptom severity whereas depression severity directly influences QoL in TD. Results imply that to improve QoL in TD patients, treatment should primarily focus on diminishing OC and depressive symptom severity rather than focusing on tic reduction.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Qualidade de Vida , Síndrome de Tourette/psicologia , Adolescente , Adulto , Criança , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Tiques/etiologia , Tiques/psicologia , Síndrome de Tourette/complicações
2.
Afr J Reprod Health ; 23(2): 44-55, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31433593

RESUMO

This study investigated the prevalence of Obsessive-Compulsive Disorder (OCD) symptoms and their relationship with pregnancy- related anxiety, perinatal depression and clinical anger among pregnant black African women in South Africa. The sample consisted of 206 women attending their antenatal check-ups at the Mankweng, Nobody, and Rethabile Clinics, and the Mankweng hospital in the Capricorn District, Limpopo Province. Quantitative data was collected from a convenience sample, within a cross-sectional survey design. First, the prevalence of OCD among the women was established. Then Pearson's correlation analysis was used to establish if there was a linear relationship between the variables of the study. Variables that were related were then subjected to regression analysis, seeking to establish if the independent variables, pregnancy-related anxiety, perinatal depression and clinical anger, together with other pregnancy-related variables, would predict OCD symptoms. When correlational analysis was conducted, the patient characteristics of having undergone a medical check-up, and having previously delivered a live baby generally did not correlate with any of the main scales measuring OCD symptoms, perinatal depression, pregnancy-related anxiety and clinical anger (p<0.05). Almost 39.5% of the pregnant women could be classified as obsessive-compulsive disordered, when using the cut-off score of 36. Furthermore, findings from regression analyses indicated that higher age, the number of gestation weeks, having previously experienced pregnancy-related complications, perinatal depression, pregnancy-related anxiety and clinical anger were variably positive predictors of the Revised version of the Obsessive-Compulsive Inventory (OCI-R) measured OCD symptoms. The predictors were specific to each of the symptoms. It can be concluded from the study that there is a relationship between OCD symptoms and all the independent variables used.


Assuntos
Ansiedade/etiologia , Depressão/etiologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Complicações na Gravidez/epidemiologia , Adolescente , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Centros Comunitários de Saúde , Comorbidade , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Transtorno Obsessivo-Compulsivo/diagnóstico , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/psicologia , Prevalência , Fatores Socioeconômicos , África do Sul/epidemiologia , Inquéritos e Questionários , Adulto Jovem
3.
Pan Afr Med J ; 33: 47, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448010

RESUMO

Introduction: Hypogonadism refers to a syndrome that results from failure of gonads to function properly. The main concern is considerable rise in morbidity, as shown by increased cardiovascular risk, infertility, osteoporosis and above all, the psychological impact on the life of the patients with hypogonadism. Judicious steroid replacement and culturally-sensitive psychological support before and during steroid therapy remains the key tool in the management of this condition. The present study aimed at filling the knowledge gap on hypogonadism in Cameroon. Methods: We conducted a cross-sectional study over a period of 12 months, in 3 reference hospitals of Cameroon. We included males and females diagnosed with hypogonadism, aged 16 to 50 years and 16 to 45 years respectively. After a complete clinical examination, patients were invited to fill the modified middlesex hospital questionnaire for psychoneurotic evaluation. Results: We recruited 59 patients with a sex ratio of 1:1. The mean age of the females and males were 27.7 ± 9.1years and 30.8 ± 11.7 years respectively. Normosmic Idiopathic Hypogonadotropic Hypogonadism (NIHH) was the most common presentation. Compulsive obsessive traits, phobic anxiety and hysterical trait, were most pronounced in these patients. Testosterone titers significantly correlated positively with testicular size and negatively with body mass index (BMI). A significant positive correlation was found between the testicular volumes measured with ultrasound (US) and with the orchidometer. Conclusion: Normosmic idiopathic hypogonadotropic hypogonadism is the most common presentation of hypogonadism in the study population. There is a significant psychosocial impact requiring further investigation and attention.


Assuntos
Hipogonadismo/fisiopatologia , Testículo/diagnóstico por imagem , Testosterona/sangue , Adolescente , Adulto , Índice de Massa Corporal , Camarões , Estudos Transversais , Feminino , Humanos , Hipogonadismo/epidemiologia , Hipogonadismo/psicologia , Histeria/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtornos Fóbicos/epidemiologia , Ultrassonografia , Adulto Jovem
4.
PLoS One ; 14(7): e0218955, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31276509

RESUMO

OBJECTIVE: In this study, it is aimed to determine obsessive compulsive-related disorders (OCRDs) comorbidity among the patients with obsessive compulsive disorder (OCD) and compare patients with OCD with or without comorbid OCRDs in terms of the severity of their OCD symptoms, symptom dimensions, and comorbidity with other axis I disorders. METHODS: The study included 90 patients diagnosed as having OCD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for OCRDs were used to determine the presence of OCRDs. In order to determine the symptom dimensions and severity of these individuals' OCD symptoms, we administered the Dimensional Obsessive Compulsive Scale (DOCS) and The Yale-Brown Obsessive Compulsive Scale (Y-BOCS). RESULTS: In our study, 20% of the patients with OCD simultaneously met the criteria for at least one OCRD, we also found that a significantly greater proportion of this group were men. None of the mentioned disorders was associated with any symptom dimensions we evaluated using DOCS. In addition, no differences were found in the severity of OCD symptoms and comorbid axis I disorders between the group with comorbid OCRDs and the group without comorbid OCRDs. DISCUSSION: There was no significant relationship between the symptom dimensions of OCD and OCRDs. It is found that OCRD comorbidity does not increase the severity of OCD symptoms and the prevalence of an axis I diagnosis.


Assuntos
Transtorno da Personalidade Compulsiva/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtorno Obsessivo-Compulsivo/diagnóstico , Índice de Gravidade de Doença , Adolescente , Adulto , Comorbidade , Transtorno da Personalidade Compulsiva/epidemiologia , Transtorno da Personalidade Compulsiva/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Prevalência , Turquia/epidemiologia , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-31152643

RESUMO

BACKGROUND: Fearful and anxious behaviour is especially common in children, when they come across new situations and experiences. The difference between normal worry and an anxiety disorder is in the severity and in the interference with everyday life and normal developmental steps. Many longitudinal studies in children suggest that anxiety disorders are relatively stable over time and predict anxiety and depressive disorders in adolescence and adulthood. For this reason, the early diagnostic and treatment are needed. Researchers supposed that anxiety is a result of repeated stress. Additionally, some genetic, neurobiological, developmental factors are also involved in the aetiology. METHODS AND SUBJECTS: The aim of this article is to summarize and to present our own results obtained with the assessment and treatment of different forms of anxiety disorders in children and adolescents such as: Posttraumatic Stress Disorder (PTSD), Obsessive Compulsive Disorder (OCD), Dental anxiety, General Anxiety Disorder (GAD), and Anxious-phobic syndrome. Some results are published separately in different journals. a) Post Traumatic Stress Disorder (PTSD) in 10 young children aged 9 ± 2, 05 y. is evaluated and discussed concerning the attachment quality. b) The group with OCD comprises 20 patients, mean age 14,5 ± 2,2 years, evaluated with Eysenck Personality Questionnaire (EPQ), Child behaviour Checklist (CBCL), K-SADS (Schedule for Affective Disorders and Schizophrenia for School age children), Beck Depression Inventory (BDI), SCWT (Stroop Colour Word task), WCST (Wisconsin Card Scoring test). c) Dental stress is evaluated in a group of 50 patients; mean age for girls 11,4 ± 2,4 years; for boys 10,7 ± 2,6 years, evaluated with (General Anxiety Scale (GASC), and Eysenck Personality Questionnaire (EPQ). d) Minnesota Multiphasic Personality Inventory (MMPI) profiles obtained for General Anxiety Disorder in 20 young females and 15 males aged 25,7± 5,35 years, and a group with Panic attack syndrome N=15 aged 19,3±4,9 years are presented and discussed by comparison of the results for healthy people. e) Heart Rate Variability (HRV) was applied for assessment and treatment in 15 anxious-phobic patients, mean age 12, 5±2,25 years and results are compared with other groups of mental disorder. RESULTS: Children with PTSD showed a high level of anxiety and stress, somatization and behavioural problems (aggression, impulsivity, non-obedience and nightmares), complemented by hypersensitive and depressed mothers and misattachment in the early period of infancy. Consequently, the explanation of the early predisposition to PTSD was related to be the non-developed Right Orbital Cortex. The later resulted from insecure attachment confirmed in all examined children. The obtained neuropsychological profile of children with OCD confirmed a clear presence of obsessions and compulsions, average intellectual capacities, but the absence of depressive symptoms. Executive functions were investigated through Event Related Potentials on Go/NoGo tasks. Results showed that no significant clinical manifestations of cognitive dysfunction among children with OCD in the early stage of the disorder are present, but it could be expected to be appearing in the later stage of the disorder if it is no treated. In a study of 50 children randomly selected, two psychometric instruments were applied for measuring general anxiety and personal characteristics. It was confirmed that there was presence of significant anxiety level (evaluated with GASC) among children undergoing dental intervention. The difference in anxiety scores between girls and boys was also confirmed (girls having higher scores for anxiety). Results obtained with EPQ showed low psychopathological traits, moderate extraversion and neuroticism, but accentuated insincerity (L scale). L scales are lower by increasing of age, but P scores rise with age, which can be related to puberty. No correlation was found between personality traits and anxiety except for neuroticism, which is positively correlated with the level of anxiety. The obtained profiles for MMPI-201 in a group of patients with general anxiety are presented as a figure. Females showed only Hy peak, but in the normal range. However, statistics confirmed significant difference between scores in anxiety group and control (t= 2, 25164; p= 0, 038749). Males showed Hs-Hy-Pt peaks with higher (pathological) scores, related to hypersensitivity of the autonomic nervous system, as well as with manifested anxiety. Calculation confirmed significant difference between control and anxiety in men (t= 15.13, p=0.000). Additionally, MMPI profiles for patients with attack panic syndrome are also presented as a figure. Control scales for females showed typical V form (scales 1 and 3) related to conversing tendencies. In addition, females showed peaks on Pt-Sc scales, but in normal ranges. Pathological profile is obtained in males, with Hy-Sc peaks; this profile corresponds to persons with regressive characteristics, emotionally instable and with accentuated social withdraw. Heart rate variability (HRV) is a measure of the beat to beat variability in heart rate, related to the work of autonomic nervous system. It may serve as a psychophysiological indicator for arousal, emotional state and stress level. We used HRV in both, the assessment and biofeedback training, in a group of anxious-phobic and obsessive-compulsive school children. Results obtained with Eysenck Personality Questionnaire showed significantly higher psychopathological traits, higher neuroticism and lower lie scores. After 15 session HRV training very satisfying results for diminishing stress and anxiety were obtained.


Assuntos
Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Medo/psicologia , Adolescente , Adulto , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/terapia , Criança , Ansiedade ao Tratamento Odontológico/epidemiologia , Ansiedade ao Tratamento Odontológico/psicologia , Ansiedade ao Tratamento Odontológico/terapia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/terapia , Epilepsia Pós-Traumática/epidemiologia , Epilepsia Pós-Traumática/psicologia , Epilepsia Pós-Traumática/terapia , Feminino , Humanos , Masculino , Neuroticismo , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/psicologia , Transtornos Fóbicos/terapia , Escalas de Graduação Psiquiátrica , Psicometria , Adulto Jovem
6.
Asian J Psychiatr ; 43: 87-90, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31108398

RESUMO

Obsessive-compulsive disorder (OCD) with comorbid bipolar affective disorder (BPAD) is often faced with a therapeutic challenge. Pharmacological treatment strategy engaged towards alleviating symptoms in OCD has the propensity to precipitate a manic switch in patients with comorbid BPAD. Advanced non-invasive brain stimulation techniques like high definition transcranial direct current stimulation (HD-tDCS) may target the symptoms of OCD while preventing a probable manic switch in a vulnerable population. In this case series, we targeted OC symptoms in three patients by giving 2 mA of anodal HD-tDCS at their pre-SMA (localized using 10/10 EEG system) with 4 surrounding return electrodes of opposite polarity for 20 min of two sessions having an intersession gap of 20 min receiving a maximum of 20 sessions. We found that the patients showed significant improvement (more than 25%) in their OC symptoms while having no affective side effects and this effect was replicated in one of the two patients in repeating the treatment for relapse. This case series highlights the efficacy and durability of the effect of HD-tDCS as an add-on treatment modality in three patients who were treated for OC symptoms in the context of a comorbid bipolar disorder, two of them receiving repeat courses on relapse.


Assuntos
Transtorno Bipolar/terapia , Transtorno Obsessivo-Compulsivo/terapia , Estimulação Transcraniana por Corrente Contínua/métodos , Adolescente , Adulto , Transtorno Bipolar/epidemiologia , Comorbidade , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/epidemiologia , Estimulação Transcraniana por Corrente Contínua/efeitos adversos , Resultado do Tratamento
7.
Asian J Psychiatr ; 43: 67-69, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31096141

RESUMO

BACKGROUND: There is no population based study about prevalence of psychiatric conditions in Kermanshah. A screening study reported the rate of 39.1% for psychiatric disorders. METHODS: This is the second phase of a larger study. From those with a positive screening, 15% were randomly selected and interviewed face-to-face at home by trained clinical psychologists with Farsi version of the structured clinical interview for DSM-IV (SCID) I and II. RESULTS: The original sample was 2102 participants, from those 319 individuals were interviewed. Only 15 participants (4.7% of the positively screened sample) had a negative result. Major depressive disorder (8.3%), generalized anxiety disorder (4.7%), obsessive compulsive disorder (4.6%) and obsessive compulsive personality disorder (3.3%) were the most common disorders diagnosed within this sample. CONCLUSION: This population based study gives prevalence rates for psychiatric disorders in Kermanshah for the first time. Results can be the basis for health care policy makers and further studies.


Assuntos
Transtornos Mentais/epidemiologia , Adulto , Idoso , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Entrevista Psicológica , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/epidemiologia , Prevalência , Adulto Jovem
8.
J Behav Addict ; 8(2): 242-248, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31079471

RESUMO

BACKGROUND AND AIMS: Compulsive sexual behavior disorder (CSBD) will be included in ICD-11 as an impulse-control disorder. CSBD also shares clinical features with obsessive-compulsive spectrum disorders (OCSDs) and behavioral addictions. There has been relatively little systematic investigation of CSBD in obsessive-compulsive disorder (OCD), the paradigmatic compulsive disorder. We aimed to determine prevalence of CSBD in OCD, and its associated sociodemographic and clinical features, including associated comorbidity, to learn more about the nature of CSBD. METHODS: Adult outpatients with current OCD (N = 539) participated in this study. The Structured Clinical Interview for OCSDs was used to diagnose OCSDs (Tourette's syndrome, compulsive shopping, pathological gambling, kleptomania, pyromania, intermittent explosive disorder, self-injurious behavior, and CSBD). Prevalence rates of OCSDs in male versus female patients as well as comorbid disorders in OCD patients with and without CSBD were compared. RESULTS: Lifetime prevalence of CSBD was 5.6% in patients with current OCD and significantly higher in men than women. OCD patients with and without CSBD were similar in terms of age, age of onset of OCD, present OCD illness severity, as well as educational background. Lifetime prevalence rates of several mood, obsessive-compulsive, and impulse-control disorders were considerably elevated in patients with lifetime CSBD. DISCUSSION AND CONCLUSIONS: A substantive number of OCD patients suffered from CSBD. CSBD in OCD was more likely comorbid with other mood, obsessive-compulsive, and impulse-control disorders, but not with disorders due to substance use or addictive behaviors. This finding supports conceptualization of CSBD as a compulsive-impulsive disorder.


Assuntos
Comportamento Compulsivo/epidemiologia , Comportamento Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Disfunções Sexuais Psicogênicas/epidemiologia , Disfunções Sexuais Psicogênicas/psicologia , Adolescente , Adulto , Idoso , Comorbidade , Escolaridade , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Prevalência , Índice de Gravidade de Doença , Distribuição por Sexo , Adulto Jovem
9.
Depress Anxiety ; 36(7): 586-595, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31066996

RESUMO

BACKGROUND: Obsessive-compulsive symptoms (OCS) in youth are common, have heterogeneous manifestations, and have been shown to be associated with serious psychopathology. While early-life trauma exposure is associated with increased risk for obsessive-compulsive disorder (OCD), its association with different OCS and its clinical relevance for serious psychopathology is unclear. Here we aimed to evaluate associations among traumatic stressful events (TSE), OCS, and serious psychiatric conditions in community youth. METHODS: We studied nonmental-help seeking youths from the Philadelphia Neurodevelopmental Cohort (N = 7054, aged 11-21, 54% females, 52% prepubertal), assessed for lifetime TSE exposure and OCS. Regression models investigated cross-sectional associations of TSEs with OCS, and associations with depression, suicide ideation and psychosis. Models examined sex and puberty effects, controlling for age and socioeconomic status. RESULTS: Trauma exposure was associated with higher OCS rates, especially in females (Trauma × Sex interaction Wald = 7.93, p = 0.005) and prepuberty (Trauma × Puberty interaction Wald = 7.68, p = 0.006). TSEs were associated with all OCS manifestations, most prominently with bad intrusive thoughts (odds ratio [OR] = 1.63). Assaultive TSEs, especially sexual assault, showed stronger associations with OCS compared with nonassaultive TSEs. While TSEs and OCS were independently associated with depression, suicide ideation, and psychosis, a significant interaction was observed only in association with increased rates of psychosis (Trauma × OCS interaction Wald = 5.08, p = 0.024). CONCLUSION: Early-life trauma is associated with OCS in a dose-response manner, more so in females and prepuberty. The trauma-OCS association varied by load, type of trauma, and by OCS subtypes. Trauma-OCS appears a detrimental combination in association with psychosis.


Assuntos
Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Trauma Psicológico/epidemiologia , Trauma Psicológico/psicologia , Adolescente , Criança , Estudos de Coortes , Comorbidade , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Psicopatologia , Transtornos Psicóticos/epidemiologia , Índice de Gravidade de Doença , Fatores Sexuais , Delitos Sexuais/psicologia , Delitos Sexuais/estatística & dados numéricos , Ideação Suicida , Adulto Jovem
10.
Curr Psychiatry Rep ; 21(5): 36, 2019 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-31016410

RESUMO

PURPOSE OF REVIEW: This review highlights recent research regarding gender differences in OCD, with a focus on prevalence, course of illness, symptom presentation, comorbidity, and treatment response. RECENT FINDINGS: Overall, findings remain mixed. OCD may be more common among males in childhood, but is more common among females in adolescence and adulthood. Males tend to report an earlier age of onset and present with symptoms related to blasphemous thoughts. Females often describe symptom onset as occurring during or after puberty or pregnancy and present with symptoms related to contamination and/or aggressive obsessions. Females also tend to report significantly higher depression and anxiety. There are no reported gender differences in treatment outcome. Gender may play a role in the onset, presentation, and impact of OCD symptoms. However, more work is needed to account for differences across studies, with one promising future direction being the study of reproductive hormones.


Assuntos
Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/terapia , Caracteres Sexuais , Comorbidade , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/psicologia , Prevalência
11.
Depress Anxiety ; 36(6): 533-542, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30990937

RESUMO

BACKGROUND: Recent findings suggest an association between attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). Thus, we evaluated the clinical associated features of ADHD in a large sample of adult OCD patients. METHODS: A cross-sectional study including 955 adult patients with OCD from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinical characteristics in adult OCD patients with and without comorbid ADHD were compared using Fisher's exact test, t-tests or Mann-Whitney tests. Bivariate analyses were followed by logistic regression analysis to identify clinical characteristics independently associated with ADHD comorbidity. RESULTS: The lifetime prevalence of ADHD in adult OCD patients was 13.7%. The current results indicate that OCD + ADHD patients were more severe, had an earlier onset of the obsessive-compulsive symptoms, a higher history of rheumatic fever, with higher frequencies of sensory phenomena and comorbidity with Tourette syndrome. They also had an increased risk for academic impairment and suicide attempts. CONCLUSION: Adult OCD patients with ADHD present some specific clinical features and may represent a special subgroup of adult OCD. Future studies should focus on the development of interventions more tailored to the phenotype of this subgroup of patients.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Sucesso Acadêmico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Comorbidade , Correlação de Dados , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Prevalência , Tentativa de Suicídio/estatística & dados numéricos , Síndrome de Tourette/epidemiologia , Adulto Jovem
12.
Asian J Psychiatr ; 42: 34-41, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30951931

RESUMO

There is an exponential growth in the field of biomedical literature over the years. Although numerous articles are published every year, few of them present important conceptual advances in that particular field and are found to be influential in the evolution of the field. The number of citations a publication receives can be used as a proxy marker of its impact on the field. Hence we aimed to analyze the top cited articles (n = 100) on obsessive compulsive disorder (OCD) as of July 2018. Google scholar database was searched using a freely available software, Publish or Perish. Information related to number of citations, publication title, publication year, name of the journal, country of origin, author details, institution of origin, article type, and article design. The original research articles were further classified into descriptive/epidemiology, mechanism, management, scale/measurement, imaging and medical psychiatry. The citation classics suggest that clinical trials/management, epidemiology and neuroimaging were the most researched areas in the OCD research. These citation classics provide an important insight into the historical developments, like the role of serotonin and caudate in OCD. This approach of citation analysis provides an opportunity to retrieve the classic articles on OCD, and describes the trends in OCD research.


Assuntos
Bibliometria , Transtorno Obsessivo-Compulsivo , Psiquiatria/estatística & dados numéricos , Bases de Dados Bibliográficas , Humanos , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/etiologia , Transtorno Obsessivo-Compulsivo/terapia
13.
Int J Psychiatry Clin Pract ; 23(3): 215-224, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30987479

RESUMO

Objective: We aimed to describe the epidemiology of obsessive-compulsive disorder (OCD) and related subthreshold symptoms in the general population of Greece and to assess the comorbidity, use of health services and impact on quality of life of these syndromes in the general population. Methods: This was a secondary analysis of the 2009-2010 general population Greek psychiatric morbidity survey (4902 participants living in private households, response rate 54%). Psychiatric disorders were assessed with the revised Clinical Interview Schedule (CIS-R). Quality of life was assessed with the EuroQoL EQ-5D. Results: 1.69% of the participants (95% confidence interval [CI]: 1.33%-2.05%) met criteria for current OCD while 2.79% met criteria for subthreshold obsessive-compulsive symptoms (95%CI: 2.33%-3.26%). In the adjusted analysis few sociodemographic associations remained statistically significant. Although the full-blown syndrome was more severe in terms of comorbidity and quality of life our results showed that even subthreshold obsessive-compulsive symptoms were associated with significant comorbidity and reductions in quality of life. Use of mental health services was small. Conclusions: OCD is an under-treated public health problem that needs more attention in Greece and elsewhere. Provision of specialised mental health services should be a priority for publicly funded national health systems. Keypoints OCD is common in the general population of Greece with few sociodemographic associations apart from subjective financial difficulties. The comorbidity pattern of the full-blown syndrome versus the subthreshold obsessive-compulsive symptoms is similar and differs in magnitude in the expected way. Quality of life in OCD is greatly reduced especially when there is chronicity and/or comorbidity with depression. Use of services is limited but comorbidity with depression may increase the chances of consultation with a mental health professional.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Qualidade de Vida , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Comorbidade , Estudos Transversais , Feminino , Grécia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Sintomas Prodrômicos , Caracteres Sexuais , Adulto Jovem
14.
Nord J Psychiatry ; 73(2): 111-117, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30870046

RESUMO

The presence of comorbid conditions associated with paediatric obsessive-compulsive disorder (OCD) is reported to range from 50 to 80% and to have an impact on treatment outcome. Accurate identification of comorbid psychiatric disorders is necessary in order to provide personalised care. Reliable and valid diagnostic interviews are essential in the process of establishing the correct diagnoses. The objective of this study was to evaluate the convergent and divergent validity of four diagnose categories generated by the Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime Version (K-SADS-PL). The diagnose categories were: anxiety, depression, attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD). The K-SADS-PL was applied in a clinical sample of youth aged 7-17 years (N = 269), who were participants in the Nordic long-term OCD-treatment study (NordLOTS). Youth and parents completed measures to evaluate symptoms of anxiety, depression, ADHD, and ODD. Convergent and divergent validity of K-SADS-PL anxiety diagnosis was supported based on both anxiety self- and parent-reports. Similarly, support was found for convergent and divergent validity of ADHD and ODD diagnoses. For depressive disorder, support for convergent validity was found based on the depression self-report. Support for divergent validity of depression was found based on both the depression self- and parent-reports. Results of the present study suggest that the K-SADS-PL generates valid diagnoses of comorbid anxiety disorders, depression disorders, ODD, and ADHD in children and adolescents with OCD.


Assuntos
Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia , Escalas de Graduação Psiquiátrica/normas , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia , Adolescente , Criança , Comorbidade , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtorno Obsessivo-Compulsivo/psicologia , Psicometria , Reprodutibilidade dos Testes , Psicologia do Esquizofrênico
15.
Behav Ther ; 50(2): 353-366, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30824251

RESUMO

Exposure-based interventions are a core ingredient of evidence-based cognitive-behavioral treatment (CBT) for anxiety disorders, posttraumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). However, previous research has documented that exposure is rarely utilized in routine care, highlighting an ongoing lack of dissemination. The present study examined barriers for the dissemination of exposure from the perspective of behavioral psychotherapists working in outpatient routine care (N = 684). A postal survey assessed three categories of barriers: (a) practicability of exposure-based intervention in an outpatient private practice setting, (b) negative beliefs about exposure, and (c) therapist distress related to the use of exposure. In addition, self-reported competence to conduct exposure for different anxiety disorders, PTSD, and OCD was assessed. High rates of agreement were found for single barriers within each of the three categories (e.g., unpredictable time management, risk of uncompensated absence of the patient, risk of decompensation of the patient, superficial effectiveness, or exposure being very strenuous for the therapist). Separately, average agreement to each category negatively correlated with self-reported utilization of exposure to a moderate degree (-.35 ≤ r ≤ -.27). In a multiple regression model, only average agreement to barriers of practicability and negative beliefs were significantly associated with utilization rates. Findings illustrate that a multilevel approach targeting individual, practical, and systemic barriers is necessary to optimize the dissemination of exposure-based interventions. Dissemination efforts may therefore benefit from incorporating strategies such as modifying negative beliefs, adaptive stress management for therapists, or increasing practicability of exposure-based interventions.


Assuntos
Terapia Implosiva/métodos , Estresse Ocupacional/psicologia , Pessimismo/psicologia , Relações Profissional-Paciente , Autorrelato , Adulto , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Terapia Cognitivo-Comportamental/normas , Feminino , Alemanha/epidemiologia , Humanos , Terapia Implosiva/normas , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Estresse Ocupacional/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Inquéritos e Questionários
16.
Behav Ther ; 50(2): 380-394, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30824253

RESUMO

Both contact contamination (CC) and mental contamination (MC) fears-which combined represent the most common manifestation of obsessive-compulsive disorder (OCD)-have been widely associated with disgust propensity. However, extant research explored this relationship using measures assessing only pathogen-related disgust, not taking into account the potential role played by sexual and moral disgust, despite literature about MC suggesting that this might be particularly relevant. In Study 1, the psychometric properties of the Italian version of the Three Domains of Disgust Scale (TDDS) were assessed in a large Italian community sample. Exploratory and confirmatory factor analyses confirmed the three-factor structure of the TDDS. The scale also showed good internal consistency and construct validity. In Study 2, the differential patterns of relationships between CC and MC and the three disgust domains were explored in an Italian clinical OCD sample using a path analytic approach. The TDDS-Pathogen subscale was a unique predictor of CC while the TDDS-Sexual subscale was a unique predictor of MC, after controlling for anxiety and depression. Surprisingly, the TDDS-Moral subscale was not a predictor of either domain of contamination fear. Limitations and clinical implications are discussed.


Assuntos
Asco , Medo/psicologia , Modelos Psicológicos , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Fatorial , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/epidemiologia , Adulto Jovem
17.
Psychiatry Res ; 274: 274-279, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30825727

RESUMO

Obsessive compulsive-disorder (OCD) is a common mental illness characterized by the presence of obsessions and/or compulsions. Symptom presence and severity is typically evaluated through the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). However, miscellaneous symptoms embedded within the Y-BOCS Symptom Checklist have often been overlooked despite being associated with certain dimensions. In this study, we used exploratory factor analysis and logistic regression to explore the relationship between various miscellaneous symptoms and OCD symptom dimensions among 123 Chinese adults with OCD. A four-dimensional model was factorially derived: Obsessions, Symmetry/Ritual, Contamination/Cleaning and Contamination/Cleaning. In general, 11 out of 17 miscellaneous symptoms were associated with one or more of the symptom dimensions. Among them, the Obsessions dimension was significantly associated with seven miscellaneous symptoms: "Fear of not saying just the right thing," "Intrusive (non-violent) images," "Intrusive nonsense sounds, words", etc. The Symmetry/Ritual dimension was significantly associated with "Need to tell, ask, or confess." The Contamination/Cleaning dimension was related to "Need to know or remember". The Hoarding/Religion dimension was related to "Fear of losing things," and "Superstitious fears". Results contribute to the clinical assessment, diagnosis and treatment of Chinese patients with OCD by understanding the extent to which certain miscellaneous symptoms are associated with primary symptom dimensions.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Sintomas Comportamentais/diagnóstico , Sintomas Comportamentais/psicologia , Medo/psicologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/psicologia , Adolescente , Adulto , Sintomas Comportamentais/epidemiologia , Escalas de Graduação Psiquiátrica Breve/normas , Comportamento Compulsivo/diagnóstico , Comportamento Compulsivo/epidemiologia , Comportamento Compulsivo/psicologia , Feminino , Colecionismo/diagnóstico , Colecionismo/epidemiologia , Colecionismo/psicologia , Humanos , Masculino , Rememoração Mental/fisiologia , Pessoa de Meia-Idade , Comportamento Obsessivo/diagnóstico , Comportamento Obsessivo/epidemiologia , Comportamento Obsessivo/psicologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Adulto Jovem
18.
BMC Psychiatry ; 19(1): 94, 2019 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-30898103

RESUMO

BACKGROUND: Unwanted, intrusive thoughts of harm-related to the infant are reported by the vast majority of new mothers, with half of all new mothers reporting unwanted, intrusive thoughts of harming their infant on purpose. Thoughts of intentional harm, in particular, are distressing to women, their partners and the people who care for them. While maternal, unwanted and intrusive thoughts of infant-related harm are known to be associated with obsessive compulsive disorder (OCD) and depression, preliminary evidence suggests that they are not associated with an increased risk of harm to infants. Perinatal care providers and policy makers, as well as new mothers and their partners require evidence-based information in order to respond appropriately to these types of thoughts. The purpose of this research is to address important gaps regarding the (a) prevalence and characteristics of intrusive, unwanted thoughts of baby-related harm, (b) their association (or lack thereof) with child abuse, and (c) the prevalence and course of obsessive-compulsive disorder and depression in the perinatal period. METHODS: Participant were 763 English-speaking women and recruited during pregnancy. In this province-wide study in British Columbia, participants were recruited proportionally from hospitals, city centers and rural communities between January 23, 2014 and September 09, 2016. Participants were administered online questionnaires and diagnostic interviews over the phone at 33-weeks gestation, 7-weeks postpartum and 4-months postpartum. The study assessed intrusive and unwanted thoughts of harm related to the infant, obsessive-compulsive disorder (OCD) and major depressive episode (MDE) disorders and symptomatology, sleep, medical outcomes, parenting attitudes, and infant abuse. DISCUSSION: There is a scarcity of literature concerning maternal unwanted, intrusive, postpartum thoughts of infant-related harm and their relationship to child harming behaviors, OCD and depression. This longitudinal cohort study was designed to build on the existing research base to ensure that policy developers, child protection workers and health-care providers have the guidance they need to respond appropriately to the disclosure of infant-related harm thoughts. Thus, its main goals will be to investigate whether intrusive postpartum thoughts of infant-related harm are a risk factor for child abuse or the development of OCD.


Assuntos
Maus-Tratos Infantis/psicologia , Depressão Pós-Parto/psicologia , Transtorno Depressivo Maior/psicologia , Mães/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Pensamento , Adulto , Colúmbia Britânica/epidemiologia , Maus-Tratos Infantis/prevenção & controle , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/terapia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/terapia , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/terapia , Período Pós-Parto/psicologia , Gravidez , Transtornos Puerperais/diagnóstico , Transtornos Puerperais/psicologia , Transtornos Puerperais/terapia , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-30901067

RESUMO

Trichotillomania, or hair-pulling disorder, is classified as an obsessive-compulsive spectrum disorder and is seen predominantly in females. This is a non-systematic review article focusing on the psychopathological features of hair pulling. It is speculated that hair pulling may function to provide short-term relief from stress and other unwanted emotional states, thus serving as a method of emotion regulation. The prevalence of trichotillomania ranges from 1 to 3%. The most targeted site is the scalp, and other common areas include pubic hair and facial regions such as the eyebrows, eyelashes, and beard. Individuals suffering from this disorder tend to avoid social environments due to embarrassment regarding their appearance and fears of being judged by peers. Trichotillomania is associated with significant functional impairment and increased risks of comorbid psychiatric disorders such as other body-focused repetitive behaviors, depression, anxiety, and addictive disorders. This article reviews the epidemiology, clinical features, diagnostic criteria, and psychopathology of trichotillomania with an emphasis on psychopathology and psychiatric comorbidity.


Assuntos
Transtorno Obsessivo-Compulsivo/epidemiologia , Tricotilomania/diagnóstico , Tricotilomania/psicologia , Comorbidade , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/diagnóstico , Prevalência , Prognóstico , Psicopatologia , Medição de Risco , Distribuição por Sexo , Tricotilomania/epidemiologia
20.
J Affect Disord ; 248: 155-165, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30735852

RESUMO

BACKGROUND: Postpartum anxiety (PPA) affects a substantial number of women. Despite increasing recognition of PPA, few studies have focused on perinatal anxiety and potential PPA triggers. Here we aimed to estimate the prevalence of perinatal anxiety disorders, and to explore the association between insomnia during late pregnancy and anxiety before and after childbirth. METHODS: This study was part of the large population-based Akershus Birth Cohort. We analyzed data from the hospital's birth records and questionnaire responses from pregnancy weeks 17 and 32 and postpartum week 8 (n = 1563). Perinatal anxiety symptoms were measured using the Hopkins Symptom Check List. Anxiety disorder measurements were based on questions from the Mini-International Neuropsychiatric Interview. Insomnia was measured using the Bergen Insomnia Scale. RESULTS: Among perinatal women, 10% reported symptoms of at least one anxiety disorder. The observed prevalence of obsessive-compulsive disorder was higher after delivery (4.2%) than during pregnancy (2.5%). Multiple regression analysis, with adjustment for several psychosocial and reproductive variables, indicated that insomnia during pregnancy was significantly associated with postpartum anxiety symptoms. However, this association was markedly weakened when depression variables were included in the analysis, indicating that gestational insomnia may also be a marker for a mood disorder. LIMITATIONS: Immigrant and single women were underrepresented in our sample. CONCLUSIONS: Our results suggest that anxiety disorders are prevalent during the perinatal period. Moreover, insomnia during pregnancy is associated with perinatal anxiety. Health professionals should be aware that women with gestational insomnia may have an increased risk of mood and anxiety disorders.


Assuntos
Ansiedade/complicações , Complicações na Gravidez/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Depressão/complicações , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Adulto Jovem
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