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1.
Artigo em Inglês | MEDLINE | ID: mdl-33807425

RESUMO

This study analyzed response inhibition, cognitive flexibility and working memory in three groups of patients diagnosed with obsessive-compulsive disorder, social anxiety disorder and generalized anxiety disorder, considering some variables that may influence results (nonverbal reasoning, comorbidity, use of pharmacotherapy). Neuropsychological measures were completed using a computerized Wisconsin card sorting test, Stroop color word test, go/no-go task, digits and Corsi. Significant differences were obtained among groups in cognitive flexibility and working memory variables. The obsessive-compulsive disorder (OCD) group showed the worst results. The social anxiety disorder group obtained greater effect sizes in visuospatial memory. However, significant differences between groups in visuospatial memory were no longer present when nonverbal reasoning was controlled. Comorbidity influenced interference in the OCD and generalized anxiety disorder (GAD) groups. In addition, the executive functions were differently influenced by the level of obsessions and anxiety, and the use of pharmacotherapy. Study limitations include a non-random selection of participants, modest sample size and design type (cross-sectional). The OCD group showed the worst results in flexibility cognitive and verbal working memory. Comorbidity, use of pharmacotherapy and level anxiety and obsessions were variables influencing the performance of executive functions.


Assuntos
Transtorno Obsessivo-Compulsivo , Fobia Social , Transtornos de Ansiedade/epidemiologia , Cognição , Estudos Transversais , Humanos , Memória de Curto Prazo , Testes Neuropsicológicos , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Transtorno Obsessivo-Compulsivo/epidemiologia , Fobia Social/epidemiologia
3.
J Nerv Ment Dis ; 209(4): 256-264, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33625069

RESUMO

ABSTRACT: There is an understandable concern that obsessive-compulsive disorder (OCD) may worsen during the COVID-19 pandemic, but there are little empirical data. We report the impact of COVID-19 pandemic on the short-term course of OCD. A cohort of patients with a primary diagnosis of OCD (n = 240) who were on regular follow-up at a tertiary care specialty OCD clinic in India were assessed telephonically, about 2 months after the declaration of the pandemic ("pandemic" cohort). Data from the medical records of an independent set of patients with OCD (n = 207) who were followed up during the same period, 1 year prior, was used for comparison (historical controls). The pandemic group and historical controls did not differ in the trajectories of the Yale-Brown Obsessive-Compulsive Scale scores (chi-square likelihood ratio test of the group × time interaction = 2.73, p = 0.255) and relapse rate (21% vs. 20%; adjusted odds ratio, 0.81; 95% confidence interval, 0.41-1.59; p = 0.535). Preexisting contamination symptoms and COVID-19-related health anxiety measured by the COVID-Threat Scale did not predict relapse. Only a small proportion of patients (6%) reported COVID-19-themed obsessive-compulsive symptoms. The COVID-19 pandemic, at least in the short run, did not influence the course of illness.


Assuntos
/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Adulto , Estudos de Casos e Controles , Estudos de Coortes , Progressão da Doença , Feminino , Humanos , Índia/epidemiologia , Masculino , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/terapia , Pandemias , Recidiva , Índice de Gravidade de Doença , Centros de Atenção Terciária/estatística & dados numéricos
4.
J Affect Disord ; 283: 293-301, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33578341

RESUMO

BACKGROUND: Impulsivity and perfectionism are transdiagnostic personality factors that have been studied extensively and shown to relate to externalizing and internalizing pathology respectively. Typically, these personality factors are antithesized, with impulsivity characterized by lack of control and perfectionism characterized by rigid overcontrol. METHODS: The current study (N = 1,353 undergraduate students) used latent profile analysis to identify subgroups based on impulsivity and perfectionism dimensions and tested the relations of these subgroups with the symptomatology of ten prevalent types of psychopathology (depression, worry, social anxiety, attention-deficit hyperactivity disorder inattentive subtype, attention-deficit hyperactivity disorder impulsive-hyperactive subtype, alcohol use, obsessive-compulsive disorder, posttraumatic stress disorder, restrictive eating pathology, and binge eating pathology). RESULTS: The latent profile analysis identified four meaningful subgroups: high perfectionism, high impulsivity, combined impulsivity and perfectionism, and low impulsivity and perfectionism. The combined group was the most prevalent, comprising almost half of the sample. Further, the perfectionism group had the highest scores for obsessive-compulsive disorder, worry, and restrictive eating pathology, the impulsivity group had the highest scores for alcohol use disorder, and the combined group had the highest or second-highest scores across all types of psychopathology. LIMITATIONS: Limitations include the undergraduate sample, self-report, cross-sectional study design, and high bivariate residuals. CONCLUSIONS: These findings suggest impulsivity and perfectionism can co-occur. Further, the co-occurrence of these personality traits may heighten risk for psychopathology and help explain comorbidity across internalizing and externalizing disorders. Future research should continue to investigate the presentation, prevalence, and treatment for individuals high in both perfectionism and impulsivity.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Transtorno Obsessivo-Compulsivo , Perfeccionismo , Estudos Transversais , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Humanos , Comportamento Impulsivo , Transtorno Obsessivo-Compulsivo/epidemiologia
5.
J Affect Disord ; 283: 302-309, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33578342

RESUMO

BACKGROUND: Eating disorders (ED) and obsessive-compulsive disorder (OCD) are highly comorbid, but little is known about how this comorbidity is maintained. Prior research suggests that obsessive thoughts and perfectionism may be shared maintenance factors for EDs and OCD. METHODS: The current study used network analysis to (1) identify bridge pathways in an ED-OCD comorbidity network and (2) test if perfectionism symptoms bridge between ED-OCD symptoms in a combined network model including ED, OCD, and Perfectionism symptoms. Participants (N = 1,619) were a mixed sample of undergraduate students and individuals diagnosed with EDs. RESULTS: Difficulty controlling thoughts was the symptom with the highest bridge centrality in both models, connecting with ED-related worry and doubts. In the ED-OCD-Perfectionism comorbidity network, doubts about simple everyday things and repeating things over and over bridged between ED and OCD symptoms. Additionally, specific and distinct pathways were identified between OCD and two types of ED pathology: restricting (checking compulsions and rigidity around food) and binge eating (hoarding and binge eating symptoms). LIMITATIONS: Due to the cross-sectional nature of the data, no directional inferences can be made. Due to a higher OCD symptom prevalence rate than reported in previous studies, our undergraduate sample may not be representative of other college populations. CONCLUSIONS: The presence of intrusive cognitions and maladaptive perfectionism may contribute to the maintenance of co-occurring ED and OCD symptoms. These findings begin to delineate specific pathways among OCD and ED symptoms, which can be used in the development of interventions to disrupt connections among these disorders.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Transtorno Obsessivo-Compulsivo , Perfeccionismo , Comorbidade , Estudos Transversais , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Humanos , Transtorno Obsessivo-Compulsivo/epidemiologia
7.
Int J Mol Sci ; 22(2)2021 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-33467014

RESUMO

Chronic tic disorder and Tourette syndrome are common childhood-onset neurological diseases. However, the pathophysiology underlying these disorders is unclear, and most studies have focused on the disinhibition of the corticostriatal-thalamocortical circuit. An autoimmune dysfunction has been proposed in the pathogenetic mechanism of Tourette syndrome and related neuropsychiatric disorders such as obsessive-compulsive disorder, autism, and attention-deficit/hyperactivity disorder. This is based on evidence from animal model studies and clinical findings. Herein, we review and give an update on the clinical characteristics, clinical evidence, and genetic studies in vitro as well as animal studies regarding immune dysfunction in Tourette syndrome.


Assuntos
Doenças Autoimunes/imunologia , Transtorno Obsessivo-Compulsivo/imunologia , Infecções Estreptocócicas/imunologia , Síndrome de Tourette/imunologia , Animais , Doenças Autoimunes/epidemiologia , Humanos , Linfócitos/imunologia , Microglia/imunologia , Neurônios/imunologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Infecções Estreptocócicas/epidemiologia , Síndrome de Tourette/epidemiologia , Síndrome de Tourette/genética
9.
BMC Psychiatry ; 21(1): 14, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-33413251

RESUMO

BACKGROUND: Tic disorders are childhood-onset neuropsychiatric disorders characterized by multiple motor or vocal tics with frequent comorbidities and a broad spectrum of phenotypic presentations. In this study, we aimed to investigate the clinical characteristics and comorbid neuropsychiatric conditions in pediatric patients with tic disorders. METHODS: We retrospectively reviewed the medical records of 119 pediatric patients (89 males, 30 females) who were diagnosed with tic disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) at Uijeongbu St. Mary's Hospital, Republic of Korea, between January 2012 and July 2019. RESULTS: The mean age of tic onset was 6.9 years (range, 1-14) and the mean age at diagnosis was 8 years (range, 1-17). The mean lag between tic onset and diagnosis was 13.3 months (range, 0.25-132). The most common, first-presenting tics were eye blinking (50.4%), followed by jaw or lip movement (29.4%) and throat clearing (29.4%). Thirty-seven (31.1%) patients had at least one co-occurring neuropsychiatric disorder at the time of tic diagnosis. Subtypes of tic disorders, types of initial tics, and presence of neuropsychiatric comorbidities were not associated with tic severity. Tic severity was associated with greater functional impairment and tic noticeability (p < 0.05). A relatively shorter time to diagnosis was associated with tic severity (Spearman's ρ = - 0.14, p = 0.11). CONCLUSIONS: The evolving nature of tic expression and severity, high prevalence of neuropsychiatric comorbidities, and associated functional impairments emphasize the importance of comprehensive assessment during the disease course for determining and prioritizing goals of treatment.


Assuntos
Transtorno Obsessivo-Compulsivo , Transtornos de Tique , Tiques , Síndrome de Tourette , Adolescente , Criança , Pré-Escolar , Comorbidade , Feminino , Humanos , Lactente , Masculino , Transtorno Obsessivo-Compulsivo/epidemiologia , República da Coreia/epidemiologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Transtornos de Tique/epidemiologia , Tiques/epidemiologia
10.
J Nerv Ment Dis ; 209(3): 208-211, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315799

RESUMO

ABSTRACT: It is widely agreed that obsessive-compulsive disorder (OCD) is less common among the elderly. However, several studies suggest that a third peak of OCD onset may occur after the age of 65. The onset of OCD in the elderly is unusual and mostly related to nonpsychiatric diagnoses. Nonetheless, some reports have documented late-onset OCD in older adults with no detection of cerebral abnormalities. Such differences in age of onset may be associated with phenotypical differences in disease severity, comorbidity, and treatment response across patients. In this report, we describe the case of late-onset OCD in an 80-year old man with no specific focal brain structural abnormality. The report could improve awareness of the disorder in the elderly and contribute to a better identification of clinical characteristics and additional risk factors of OCD.


Assuntos
Transtorno Obsessivo-Compulsivo/epidemiologia , Fatores Etários , Idade de Início , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/etiologia , Transtorno Obsessivo-Compulsivo/psicologia , Fatores de Risco
11.
J Affect Disord ; 281: 422-430, 2021 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-33359955

RESUMO

BACKGROUND: Obsessive-compulsive disorder (OCD) has been linked with elevated risk of suicidality. However, most previous studies have been cross-sectional, and little is known about the aetiology of the association between obsessive-compulsive symptoms (OCS) and suicidality in young adults. METHODS: Participants were members of the Child and Adolescent Twin Study in Sweden, at ages 18 (n = 9,162) and 24 (n = 3,466). Twins completed self-report measures, including assessment of OCS, suicidal ideation, and suicidal attempts. Logistic regression models tested concurrent and prospective associations of total OCS and OCS dimensions with suicidality, with and without adjustment for depression and anxiety symptoms. Genetic models tested the extent to which the main phenotypic associations were accounted for by genetic and environmental influences. RESULTS: Total OCS were significantly associated with concurrent reports of suicidality at age 18 and 24, even when controlling for depressive and anxiety symptoms. Taboo obsessions (e.g., sexual and aggressive thoughts) were more robustly associated with suicidality than other OCS dimensions, and prospectively predicted suicidality symptoms over time, even when controlling for baseline suicide attempts. Genetic factors accounted for most of the concurrent and longitudinal covariance between OCS and suicidality, with substantial non-shared environmental influences. LIMITATIONS: We relied on self-report measures and did not include diagnostic assessment of OCD. CONCLUSIONS: OCS, particularly taboo obsessions, are associated with significantly elevated risk of suicidality in late adolescence and early adulthood. This relationship is explained by a combination of common genetic liability and non-shared environmental effects, suggesting that effective OCS treatment might reduce suicidality risk in this group.


Assuntos
Transtorno Obsessivo-Compulsivo , Suicídio , Adolescente , Adulto , Criança , Estudos Transversais , Depressão , Humanos , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/genética , Estudos Prospectivos , Suécia/epidemiologia , Adulto Jovem
12.
Psychiatr Danub ; 32(3-4): 346-350, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33370731

RESUMO

The comorbidity of bipolar disorder (BD) and obsessive-compulsive disorder (OCD) is widely known. The overall rate of association between BD and OCD is very high and varies, depending on the authors, from 11% to 18%, with peaks of 21% in primarily bipolar patients. Vice versa, about 60% of patients with OCD have a second psychiatric diagnosis, which in 23% of cases turns out to be BD. The differences between the BD patients with and without OCD were so numerous and important (e.g., different onset of mood episodes, history of suicide attempts, seasonality, rapid cycling and impulsivity) that the comorbidity between BD and OCD may represent a distinct form of BD, similar to cyclothymic BD for psychopathological features. However, the comorbidity does not seem to have any impact on cognitive performance, such as there is no specific difference between patients who first develop BD and then OCD or vice versa. Anyway, the detection of the neurocognitive profile of these patients at the time of the first clinical evaluation could have clinical implications also in the therapeutic and rehabilitative management of this type of patient. Indeed, it would be desirable to develop a new model of rehabilitation that is less differentiated for both BD and OCD or for their comorbidity, also to make cognitive rehabilitation faster and less expensive. The purpose of this mini-review is to update the knowledge currently available on the impact of BD and OCD comorbidity on neurocognitive profile.


Assuntos
Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Testes de Estado Mental e Demência , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Bipolar/diagnóstico , Comorbidade , Humanos , Comportamento Impulsivo , Transtorno Obsessivo-Compulsivo/diagnóstico , Tentativa de Suicídio
13.
Artigo em Inglês | MEDLINE | ID: mdl-32987764

RESUMO

Background: This cross-sectional online survey investigates the prevalence of obsessive-compulsive disorder (OCD) symptoms at an early stage of the COVID-19 pandemic in Canada. Methods: OCD symptoms, moderate/high stress, likely generalized anxiety disorder (GAD) and likely major depressive disorder (MDD) were assessed with the Brief Obsessive-Compulsive Scale (BOCS), Perceived Stress Scale (PSS), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9) scale, respectively. Results: Out of 32,805 individuals subscribed to Text4Hope, 6041 completed an online survey; the response rate was 18.4%. Overall, 60.3% of respondents reported onset of OCD symptoms and 53.8% had compulsions to wash hands during the COVID-19 pandemic. Respondents who showed OCD symptoms only since the start of COVID-19 were significantly more likely to have moderate/high stress (z = 6.4, p < 0.001), likely GAD (z = 6.0, p < 0.001), and likely MDD (z = 2.7, p < 0.01). Similarly, respondents who engaged in compulsive hand washing were significantly more likely to have moderate/high stress (z = 4.6, p < 0.001) and likely GAD (z = 4.6 p < 0.001), but not likely MDD (z = 1.4, p = 0.16). Conclusion: The prevalence of OCD symptoms increased during the COVID-19 pandemic, at a rate significantly higher than pre-pandemic rates reported for the sample population. Presenting with OCD symptoms increased the likelihood of presenting with elevated stress, likely GAD, and likely MDD.


Assuntos
Transtornos de Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Transtorno Depressivo Maior/epidemiologia , Saúde Mental , Transtorno Obsessivo-Compulsivo/epidemiologia , Pneumonia Viral/psicologia , Betacoronavirus , Canadá/epidemiologia , Estudos Transversais , Humanos , Pandemias , Prevalência , Estresse Psicológico/epidemiologia
14.
J Anxiety Disord ; 76: 102314, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32980748

RESUMO

This brief clinical review critically assesses the use of exposure and response prevention therapy (ERP) for patients with obsessive-compulsive disorder (OCD) in light of the COVID-19 pandemic. We discuss the ethical and practical considerations that clinicians employed in past infectious disease outbreaks, as well as general safety measures routinely practiced in the conduct of exposure therapy. During this time, concerns regarding the feasibility of ERP have emerged, especially with strict guidelines on social distancing and on following other preventative behaviors. While ERP may have to be modified to follow public health guidelines, this review outlines a) how ERP has been adapted in the context of other infectious triggers; b) the potential impacts on OCD patients of attenuated ERP, and c) minimizing concerns related to litigation. A case report is provided detailing ERP personalized given COVID-19 related considerations. In all, we advise against modifying therapies in ways that may jeopardize the efficacy of patient care or progress.


Assuntos
Infecções por Coronavirus/epidemiologia , Terapia Implosiva , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/prevenção & controle , Pneumonia Viral/epidemiologia , Humanos , Transtorno Obsessivo-Compulsivo/terapia , Pandemias , Resultado do Tratamento
15.
Psychiatry Res ; 293: 113463, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32977050

RESUMO

BACKGROUND: The current COVID-19 pandemic and the consequent containment measures are leading to increasing mental health issues both in psychiatric patients and general population. OBJECTIVE: We aimed to compare the number and characteristics of emergency psychiatric consultations during the phase 1 of lockdown with respect to the same period in 2019 in a Department of Mental Health and Addiction (DMHA) located in Lombardy region. METHODS: We conducted a cross-sectional study including subjects consecutively admitted to two psychiatric emergency rooms of DMHA in Monza, Lombardy, Italy. Sociodemographic data, clinical characteristics, referred symptoms, diagnosis and information on patients' illness course following the emergency consultations were collected. No subjects were excluded for the purposes of the study. RESULTS: Between February 21st and May 3rd 2020, there was a marked reduction in the number of psychiatric emergency consultations, if compared to the same period of 2019. Subjects who were living in psychiatric residential treatment facilities, had cannabis addiction and a diagnosis of obsessive-compulsive disorder were significantly more likely to present to emergency psychiatric consultations during lockdown. CONCLUSIONS: COVID-19 epidemic may have a negative impact on more vulnerable individuals. Strategies to enhance relapse prevention and the use of alternative approaches as e-health technologies should be promoted.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Serviços de Emergência Psiquiátrica/métodos , Saúde Mental , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Adulto , Comportamento Aditivo/epidemiologia , Comportamento Aditivo/psicologia , Comportamento Aditivo/terapia , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Serviço Hospitalar de Emergência , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Pneumonia Viral/epidemiologia
16.
J Med Internet Res ; 22(9): e21915, 2020 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-32931444

RESUMO

BACKGROUND: The COVID-19 pandemic is associated with common mental health problems. However, evidence for the association between fear of COVID-19 and obsessive-compulsive disorder (OCD) is limited. OBJECTIVE: This study aimed to examine if fear of negative events affects Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores in the context of a COVID-19-fear-invoking environment. METHODS: All participants were medical university students and voluntarily completed three surveys via smartphone or computer. Survey 1 was conducted on February 8, 2020, following a 2-week-long quarantine period without classes; survey 2 was conducted on March 25, 2020, when participants had been taking online courses for 2 weeks; and survey 3 was conducted on April 28, 2020, when no new cases had been reported for 2 weeks. The surveys comprised the Y-BOCS and the Zung Self-Rating Anxiety Scale (SAS); additional items included questions on demographics (age, gender, only child vs siblings, enrollment year, major), knowledge of COVID-19, and level of fear pertaining to COVID-19. RESULTS: In survey 1, 11.3% of participants (1519/13,478) scored ≥16 on the Y-BOCS (defined as possible OCD). In surveys 2 and 3, 3.6% (305/8162) and 3.5% (305/8511) of participants had scores indicative of possible OCD, respectively. The Y-BOCS score, anxiety level, quarantine level, and intensity of fear were significantly lower at surveys 2 and 3 than at survey 1 (P<.001 for all). Compared to those with a lower Y-BOCS score (<16), participants with possible OCD expressed greater intensity of fear and had higher SAS standard scores (P<.001). The regression linear analysis indicated that intensity of fear was positively correlated to the rate of possible OCD and the average total scores for the Y-BOCS in each survey (P<.001 for all). Multiple regressions showed that those with a higher intensity of fear, a higher anxiety level, of male gender, with sibling(s), and majoring in a nonmedicine discipline had a greater chance of having a higher Y-BOCS score in all surveys. These results were redemonstrated in the 5827 participants who completed both surveys 1 and 2 and in the 4006 participants who completed all three surveys. Furthermore, in matched participants, the Y-BOCS score was negatively correlated to changes in intensity of fear (r=0.74 for survey 2, P<.001; r=0.63 for survey 3, P=.006). CONCLUSIONS: Our findings indicate that fear of COVID-19 was associated with a greater Y-BOCS score, suggesting that an environment (COVID-19 pandemic) × psychology (fear and/or anxiety) interaction might be involved in OCD and that a fear of negative events might play a role in the etiology of OCD.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Inquéritos Epidemiológicos , Transtorno Obsessivo-Compulsivo/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Universidades , Adolescente , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Medo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/psicologia , Pandemias , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Adulto Jovem
17.
Medicine (Baltimore) ; 99(35): e21395, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871865

RESUMO

BACKGROUND: Obsessive-compulsive disorder is common, chronic mental disorder, which is characterized by recurrent, unwanted, or intrusive thoughts and repetitive behaviors or mental action. Acupuncture and moxibustion, as a popular form of complementary and alternative therapy, have the advantages of low side effects, high safety, and low cost. The research showed that acupuncture and moxibustion have a good clinical efficacy on obsessive-compulsive disorder. However, there is no literature to systematically evaluate the efficacy and safety of acupuncture and moxibustion in treating obsessive-compulsive disorder. Thus, this study is aimed to evaluate the efficacy and safety of acupuncture and moxibustion for obsessive-compulsive disorder patients, providing reliable evidence for clinical application. METHODS: Randomized controlled trials of acupuncture and moxibustion combined with western medicine for the treatment of obsessive-compulsive disorder will be searched in the databases including PubMed, EMBASE, the Cochrane library, Web of science, China National Knowledge Infrastructure(CNKI), WanFang, the Chongqing VIP Chinese Science and Technology Periodical Database, and China biomedical literature database (CBM) from inception to June, 2020. In addition, Baidu, Google Scholar, International Clinical Trials Registry Platform, and Chinese Clinical Trials Registry will be searched to obtain the gray literature and relevant data that have not yet been published. Two qualified researchers will extract data and assess the risk of bias from included studies dependently. Statistical analysis is performed in RevMan 5.3 software. RESULTS: The efficacy and safety of acupuncture and moxibustion combined with western medicine for obsessive-compulsive disorder will be assessed based on the total effective rate, Hamilton Anxiety Scale score, Hamilton Rating Scale for Depression score, Clinical Global Impression score, side effects, and so on. CONCLUSIONS: The proposed systematic review and meta-analysis of acupuncture and moxibustion combined with western medicine for treating obsessive-compulsive disorder is expected to provide reliable evidence for clinical application. ETHICS AND DISSEMINATION: The private information from individuals will not publish. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/CDGTW.


Assuntos
Terapia por Acupuntura/métodos , Moxibustão/efeitos adversos , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Terapia por Acupuntura/economia , China/epidemiologia , Quimioterapia Combinada/métodos , Feminino , Humanos , Masculino , Moxibustão/economia , Transtorno Obsessivo-Compulsivo/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Resultado do Tratamento
18.
PLoS One ; 15(8): e0236688, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32750072

RESUMO

BACKGROUND: The current study aimed to assess prevalence of mental disorders during Covid-19 pandemic- and respective lockdown in Germany, and potential behaviors/states that can have protective functions on preventing severe mental problems. Assessing prevalence of mental disorders, as well as to find potential protective variables is very important in order to determine people's psychological suffering. It provides the basis for teaching possible coping styles in order to prevent a major breakdown on mental health. Prevalence on mental disorders was expected to increase during the pandemic, especially depression, (general-/and health-) anxiety, panic attacks- and disorder, as well as obsessive-compulsive disorder. Additionally, potentially protective variables, such as resilience and coping, were included. METHODS: N = 949 subjects completed an online-survey that asked for symptoms regarding depression, (health) anxiety, panic disorder, obsessive-compulsive disorder, and lock-down related behavior-starting 14 days after lockdown in Germany. RESULTS: Prevalence of mental disorders in the current sample was much higher than usual prevalence of mental disorders, with 50.6% expressing at least one mental disorder. Resilience was associated with lower risks for any mental disorder (OR = 4.23, p < .0001, 95%CI = 3.21-5.57), as well as with any other measured mental illness (all ORs between = 2.82 for obsessive-compulsive disorder and OR = 41.44 for panic disorder, all p < .001). Similar results were obtained regarding coping (focus on positive). CONCLUSION: Results are highly relevant in order to provide a glance on what substantial influence the current pandemic- and lockdown situation has on mental health across the country, and possibly across the world. Possible ways in order to prevent deterioration and help coping with the current situation are being elaborated and discussed.


Assuntos
Infecções por Coronavirus/patologia , Saúde Mental , Pneumonia Viral/patologia , Adaptação Psicológica , Adulto , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/virologia , Feminino , Alemanha/epidemiologia , Humanos , Internet , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/etiologia , Razão de Chances , Pandemias , Transtorno de Pânico/diagnóstico , Transtorno de Pânico/epidemiologia , Transtorno de Pânico/etiologia , Pneumonia Viral/virologia , Inquéritos e Questionários , Adulto Jovem
19.
Brain Behav Immun ; 89: 594-600, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32738287

RESUMO

Infection-triggered perturbation of the immune system could induce psychopathology, and psychiatric sequelae were observed after previous coronavirus outbreaks. The spreading of the Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic could be associated with psychiatric implications. We investigated the psychopathological impact of COVID-19 in survivors, also considering the effect of clinical and inflammatory predictors. We screened for psychiatric symptoms 402 adults surviving COVID-19 (265 male, mean age 58), at one month follow-up after hospital treatment. A clinical interview and a battery of self-report questionnaires were used to investigate post-traumatic stress disorder (PTSD), depression, anxiety, insomnia, and obsessive-compulsive (OC) symptomatology. We collected sociodemographic information, clinical data, baseline inflammatory markers and follow-up oxygen saturation levels. A significant proportion of patients self-rated in the psychopathological range: 28% for PTSD, 31% for depression, 42% for anxiety, 20% for OC symptoms, and 40% for insomnia. Overall, 56% scored in the pathological range in at least one clinical dimension. Despite significantly lower levels of baseline inflammatory markers, females suffered more for both anxiety and depression. Patients with a positive previous psychiatric diagnosis showed increased scores on most psychopathological measures, with similar baseline inflammation. Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, positively associated with scores of depression and anxiety at follow-up. PTSD, major depression, and anxiety, are all high-burden non-communicable conditions associated with years of life lived with disability. Considering the alarming impact of COVID-19 infection on mental health, the current insights on inflammation in psychiatry, and the present observation of worse inflammation leading to worse depression, we recommend to assess psychopathology of COVID-19 survivors and to deepen research on inflammatory biomarkers, in order to diagnose and treat emergent psychiatric conditions.


Assuntos
Transtornos de Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Pneumonia Viral/epidemiologia , Sobreviventes/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Ansiedade/imunologia , Ansiedade/psicologia , Transtornos de Ansiedade/imunologia , Transtornos de Ansiedade/psicologia , Betacoronavirus , Proteína C-Reativa/imunologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Depressão/imunologia , Depressão/psicologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/imunologia , Transtorno Depressivo/psicologia , Transtorno Depressivo Maior/imunologia , Transtorno Depressivo Maior/psicologia , Serviço Hospitalar de Emergência , Feminino , Humanos , Inflamação , Itália/epidemiologia , Tempo de Internação/estatística & dados numéricos , Contagem de Leucócitos , Contagem de Linfócitos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/imunologia , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Monócitos , Neutrófilos , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/imunologia , Transtorno Obsessivo-Compulsivo/psicologia , Pandemias , Pneumonia Viral/imunologia , Pneumonia Viral/psicologia , Índice de Gravidade de Doença , Fatores Sexuais , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/imunologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia
20.
Am J Nurs ; 120(8): 32-37, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32665509

RESUMO

If undiagnosed and untreated, pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) can suddenly and drastically disrupt the lives of previously healthy children and their families. The key to prompt diagnosis of PANDAS and its appropriate treatment is provider awareness that streptococcal infection may present with neuropsychiatric symptoms. The authors discuss the signs and symptoms that characterize PANDAS, as well as its presumed pathogenesis, and illustrate, through a composite case history, a symptom presentation, diagnostic journey, treatment course, and recovery that is representative of many PANDAS cases.


Assuntos
Doenças Autoimunes/diagnóstico , Transtorno Obsessivo-Compulsivo/diagnóstico , Infecções Estreptocócicas/diagnóstico , Antibacterianos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Antipsicóticos/uso terapêutico , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/epidemiologia , Doenças Autoimunes/fisiopatologia , Criança , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/fisiopatologia , Pais/educação , Educação de Pacientes como Assunto , Prevalência , Prognóstico , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/fisiopatologia
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