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1.
Medicina (Kaunas) ; 57(4)2021 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-33804912

RESUMO

Background and Objectives: This observational prospective study aims to examine the psychological and psychopathological impact of the pandemic stress on patients with pre-existing mood, anxiety and obsessive-compulsive disorders. Materials and Methods: The study includes 386 consecutive patients recruited from 10 March to 30 June 2020 among those being treated at the Institute of Psychopathology in Rome (Italy) with an age ≥18 years and meeting DSM-5 criteria for major depressive disorder (MDD) (35.2%), bipolar I (BD-I) (21.5%) or II (BD-II) (28.8%) disorder, obsessive-compulsive disorder (OCD) (7.5%), panic disorder (PD) (7.0%) or social anxiety (SA). A total of 34.2% had lifetime comorbid Axis I disorders and 15.3% had alcohol/drug abuse disorders. Using a semi-structured interview, we investigated if the impact of COVID-19 stress for patients has been similar, higher or lower than that of their family and friends and, for patients with relapse/symptoms worsening, if there was a relationship between the clinical condition worsening and the pandemic stress. Results: Compared with that experienced by their family members and friends, the psychological impact of pandemic stress was similar in 52.1% of the sample, better in 37.1% and worse in 10.8%. In 21 patients (5.4%), the stress triggered a recurrence or worsened the symptoms. Patients with OCD had a higher rate of worsening due to pandemic stress compared to patients with MDD (p = 0.033), although, overall, the χ2 test was not significant among primary diagnoses (χ2 = 8.368; p = 0.057). Conclusions: The psychological and psychopathological consequences of COVID-19 stress in our outpatients were very modest. The continuity of care offered during the lockdown could explain the results.


Assuntos
Transtornos de Ansiedade/psicologia , Transtorno Bipolar/psicologia , Transtorno Depressivo Maior/psicologia , Estresse Psicológico/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno de Pânico/psicologia , Fobia Social/psicologia , Estudos Prospectivos , Roma , Adulto Jovem
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
5.
Arch Sex Behav ; 50(2): 695-709, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33403534

RESUMO

This study examined the roles of religiosity, shame, obsessive-compulsive symptoms, and scrupulosity in perceived pornography addiction. We theorized that religiosity causes pornography users to feel shame regarding their use, and in turn, self-identify as addicted to pornography, especially for individuals high on one of several proposed moderators. Participants were 645-646 pornography users who believe in a theistic God. Confirmatory analyses indicated that religious primes did not have indirect or moderated indirect effects on perceived addiction. However, exploratory analyses revealed that religious primes were associated with higher shame, and in turn, perceived addiction among individuals high on both organizational religiosity and Obsessive-Compulsive Disorder compulsivity subscales. Additionally, self-reported religiosity had indirect effects on perceived addiction via shame, especially among individuals high on scrupulosity or moral disapproval of pornography.


Assuntos
Comportamento Aditivo/psicologia , Literatura Erótica/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Religião e Psicologia , Vergonha , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Princípios Morais , Autoimagem , Autorrelato , Adulto Jovem
7.
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
8.
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
10.
PLoS One ; 15(10): e0238845, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33085672

RESUMO

Cognitive behavioural therapy (CBT) which includes Exposure and Response (ERP) is a highly effective, gold standard treatment for Obsessive-Compulsive Disorder (OCD). Nonetheless, not all patients with OCD significantly benefit from CBT. This has generated interest in the potential benefits of Mindfulness-Based Interventions (MBIs), either integrated with CBT, to enhance engagement with ERP tasks, or delivered as a stand-alone, first-line or therapy to augment CBT. This paper reports on two qualitative studies that involved a thematic analysis of interview data with participants in a 10-week Mindfulness-Based ERP (MB-ERP) course (study 1) and a 9-week Mindfulness-Based Cognitive Therapy course adapted for OCD (MBCT-OCD) (study 2). Whilst MB-ERP integrated a mindfulness component into a standard ERP protocol, MBCT-OCD adapted the psychoeducational components of the standard MBCT for depression protocol to suit OCD, but without explicit ERP tasks. Three common main themes emerged across MB-ERP and MBCT-OCD: 'satisfaction with course features', 'acceptability of key therapeutic tasks 'and 'using mindfulness to respond differently to OCD'. Sub-themes identified under the first two main themes were mostly unique to MB-ERP or MBCT-OCD, with the exception of '(struggles with) developing a mindfulness practice routine' whilst most of the sub-themes under the last main theme were shared across MB-ERP and MBCT-OCD participants. Findings suggested that participants generally perceived both MBIs as acceptable and potentially beneficial treatments for OCD, in line with theorised mechanisms of change.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Atenção Plena/métodos , Transtorno Obsessivo-Compulsivo/terapia , Adulto , Inglaterra , Feminino , Humanos , Terapia Implosiva/métodos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Satisfação do Paciente , Pesquisa Qualitativa , Resultado do Tratamento , Adulto Jovem
11.
BMC Psychiatry ; 20(1): 511, 2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33081741

RESUMO

BACKGROUND: Obsessive compulsive disorder (OCD) is a distressing psychiatric disorder. Traumas may trigger or aggravate OCD symptoms. COVID-19 pandemic has coursed a global crisis and has been associated with onset of psychiatric disorders in adults. Little is known about children/adolescents with OCD. The present study aimed to examine how children/adolescents with OCD react towards COVID-19 crisis. METHODS: A questionnaire was distributed to two separate groups of children/adolescents. One group was a clinical group newly diagnosed at a specialized OCD clinic. All the children/adolescents had a current close contact to a therapist or doctor. The other group was a survey group identified through the Danish OCD Association. Most of these children/adolescents were diagnosed years ago, and their primary treatment was completed. For the clinical group, data from patient files was available. RESULTS: In both groups, but most pronounced in the survey group, participants experienced a worsening of their OCD, anxiety, and depressive symptoms. The aggravation of OCD correlated with the worsening of anxiety, depressive symptoms, and the extent of avoidance behavior. For both groups, OCD aggressive symptoms predicted a significant worsening. Poor baseline insight showed a trend to predict a symptom worsening. The worsening was most pronounced in children with early age of onset and a family history of attention deficit hyperactivity disorder. CONCLUSIONS: To our knowledge, this is one of the first studies examining the effect of COVID-19 in children/adolescents with OCD. The effect was examined in two separate populations strengthening the findings. The study points towards an influence of the OCD phenotype, baseline insight suggesting a continued vulnerability, and a family history of psychiatric disorders. TRIAL REGISTRATION: The study is approved by the Danish Data Protection Agency (1-16-02-147-20) registered 1st of April 2020. Oral and written information was given to parents and patients and written consent from patients over 15 years and parents were received.


Assuntos
Infecções por Coronavirus , Inquéritos Epidemiológicos , Transtorno Obsessivo-Compulsivo/psicologia , Pandemias , Pneumonia Viral , Adolescente , Criança , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Dinamarca , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia
12.
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
13.
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
15.
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
16.
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
17.
J Anxiety Disord ; 74: 102270, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32650220

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic sparked significant anxiety regarding viral rates and means of transmission. Heightened concerns about contamination have prompted new hygienic strategies to vigilantly guard against infection, including hand washing immediately after touching foreign objects or suspected contaminants. This has presented a critical challenge for the delivery of exposure and response prevention (ERP) therapy to individuals with contamination fears due to Obsessive Compulsive Disorder (OCD), as providers must manage not only their clients' attitudes and reactions but their own as well. In this investigation, self-identified anxiety and OCD treatment specialists (N = 139) provided demographic information, including their anxiety and OCD caseloads, and completed measures related to intolerance of uncertainty (IUS-SF; Carlton et al., 2007), beliefs about exposure therapy (TBES; Deacon et al., 2013), and emotional reactions to physical sensations (The Chills; Maruskin et al., 2012). We tested the hypothesis that intolerance of uncertainty and activation of the behavioral immune system (BIS; Schaller & Park, 2011), a mechanism theoretically activated by the prominent emergence of pathogens to protect against illness would predict attitudes toward exposure. The Chills Scale was used to assess BIS activation, a broad assessment of vasoconstriction responses associated with different emotional reactions, and includes a subscale (coldness) that evaluates vasoconstriction associated with defense against pathogens. Both coldness and OCD caseload, but not anxiety caseload or subscales of intolerance of uncertainty, emerged as significant predictors of clinicians' beliefs about exposure; increases in OCD caseload were also related to decreases in negative beliefs about exposure. Findings are useful in determining methods for aiding clinicians in developing effective approaches to contamination fears during and post-pandemic that include addressing their own BIS-related concerns and mapping out means for social behavioral norms associated with engaging in exposure treatment.


Assuntos
Ansiedade/terapia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Medo/psicologia , Terapia Implosiva , Transtorno Obsessivo-Compulsivo/terapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Adulto , Idoso , Ansiedade/psicologia , Infecções por Coronavirus/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/psicologia , Pneumonia Viral/imunologia , Incerteza
18.
BMC Psychiatry ; 20(1): 356, 2020 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-32635924

RESUMO

BACKGROUND: This study investigates the association of reassurance seeking with obsessive compulsive (OC) symptoms, dysfunctional beliefs, and negative emotions. METHODS: Reassurance Seeking Questionnaire, Obsessive-Compulsive Inventory, Obsessive Beliefs Questionnaire, Trait Anger Expression Inventory, and Guilt Inventory were applied to 53 obsessive compulsive disorder (OCD) patients and 591 non-clinical participants. RESULTS: The results showed that the severity of the OC symptoms significantly predicted the carefulness of OCD patients during reassurance seeking, indicating increased carefulness during reassurance seeking as the severity of OC symptoms increased. Moreover, feelings of guilt increased with increasing intensity of reassurance seeking. In addition, carefulness during reassurance seeking significantly predicted the level of anxiety. Responsibility/threat estimation, perfectionism/need for certainty, and importance/control of thoughts significantly predicted the OC symptoms. Moreover, the dysfunctional beliefs directly associated with an increased need to seek reassurance from different sources and seek reassurance more carefully. In terms of mediational effect, the results revealed that the individuals who had distorted beliefs were more likely to have OC symptoms and, in turn, the OC symptoms increased carefulness during reassurance seeking. The analysis of the model test revealed mostly similar results to those obtained for the clinical sample. CONCLUSIONS: The findings revealed a close relationship between OC symptoms and reassurance-seeking behaviors.


Assuntos
Transtorno Obsessivo-Compulsivo , Psicoterapia de Grupo , Transtornos de Ansiedade , Emoções , Humanos , Transtorno Obsessivo-Compulsivo/psicologia , Inquéritos e Questionários
19.
Nat Commun ; 11(1): 3364, 2020 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-32620886

RESUMO

Multiple surgical targets for treating obsessive-compulsive disorder with deep brain stimulation (DBS) have been proposed. However, different targets may modulate the same neural network responsible for clinical improvement. We analyzed data from four cohorts of patients (N = 50) that underwent DBS to the anterior limb of the internal capsule (ALIC), the nucleus accumbens or the subthalamic nucleus (STN). The same fiber bundle was associated with optimal clinical response in cohorts targeting either structure. This bundle connected frontal regions to the STN. When informing the tract target based on the first cohort, clinical improvements in the second could be significantly predicted, and vice versa. To further confirm results, clinical improvements in eight patients from a third center and six patients from a fourth center were significantly predicted based on their stimulation overlap with this tract. Our results show that connectivity-derived models may inform clinical improvements across DBS targets, surgeons and centers. The identified tract target is openly available in atlas form.


Assuntos
Conectoma/psicologia , Estimulação Encefálica Profunda/métodos , Modelos Neurológicos , Transtorno Obsessivo-Compulsivo/terapia , Adulto , Estimulação Encefálica Profunda/instrumentação , Eletrodos Implantados , Feminino , Seguimentos , Humanos , Cápsula Interna/fisiopatologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Rede Nervosa/fisiopatologia , Núcleo Accumbens/fisiopatologia , Transtorno Obsessivo-Compulsivo/fisiopatologia , Transtorno Obsessivo-Compulsivo/psicologia , Período Pós-Operatório , Período Pré-Operatório , Prognóstico , Estudos Retrospectivos , Núcleo Subtalâmico/fisiopatologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
20.
Clín. salud ; 31(2): 91-98, jul. 2020. graf, tab
Artigo em Inglês | IBECS | ID: ibc-191920

RESUMO

This study sought to delineate distinctive parenting attitudes in people with obsessive-compulsive disorder (OCD), specific emotional symptoms in their children, and the association between them. Forty OCD parents and their children were compared with 37 parents with adjustment disorders and their children by using standardized clinical questionnaires. Children of OCD parents exhibited significantly greater (subclinical) emotional symptoms when compared with children of non-OCD parents. After controlling for parents' and children's depression and anxiety symptoms, OCD parents reported significantly poorer parenting attitudes overall relative to non-OCD parents. The presence of sexual/somatic obsessions in OCD parents predicted anxiety symptom severity among their children, but both relationships were mediated by parental involvement. These findings indicate the importance of addressing and treating the distinctive parenting attitudes among people with OCD and its influence on their children's emotional symptoms


Este estudio pretende delimitar las actitudes parentales distintivas en personas con trastorno obsesivo-compulsivo (TOC), los síntomas emocionales específicos en sus hijos y la asociación entre ambos. Cuarenta padres con TOC y sus hijos fueron comparados con 37 padres con trastornos adaptativos y sus hijos mediante el uso de cuestionarios clínicos estandarizados. Los hijos de padres con TOC manifestaron significativamente más síntomas emocionales (nivel subclínico) en comparación con los hijos de padres con trastornos adaptativos. Tras controlar el efecto de los síntomas de depresión y ansiedad de los padres y los niños, los padres con TOC indicaban actitudes parentales significativamente peores que las de los padres con trastornos adaptativos. La presencia de obsesiones sexuales/somáticas en los padres con TOC predecía la severidad de los síntomas de ansiedad en sus hijos, si bien dichas relaciones estaban mediadas por el nivel de implicación parental. Estos hallazgos indican la importancia de abordar y tratar las actitudes parentales distintivas de las personas con TOC y su influencia en la sintomatología emocional de sus hijos


Assuntos
Humanos , Masculino , Feminino , Criança , Adulto , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/psicologia , Pais/psicologia , Emoções , Ansiedade/psicologia , Escalas de Graduação Psiquiátrica Breve
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