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1.
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
2.
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
3.
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
4.
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
6.
Behav Cogn Psychother ; 48(6): 751-755, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32814601

RESUMO

BACKGROUND: While exposure and response prevention (ERP) is the most effective treatment for obsessive compulsive disorder (OCD), less is known about the specific mechanisms underlying symptom change after ERP. AIMS: We tested the hypothesis that the frequency of self- and therapist-guided ERP related to the extent of symptom reduction and that this link is mediated by increased self-efficacy. METHOD: In a sample of 377 in-patients with a primary diagnosis of OCD receiving in-patient CBT, we assessed symptoms (YBOCS-SR) and self-efficacy (General Self-Efficacy Scale), before and after treatment, as well as the frequency of therapist- and self-guided ERP sessions. RESULTS: Patients with more therapist-guided ERP sessions during treatment showed more symptom reduction and the association of self-guided ERP on outcome was mediated by enhanced self-efficacy. CONCLUSIONS: These findings highlight the importance of both therapist- and self-guided ERP sessions and suggest that therapists should conduct a sufficient number of ERP sessions to optimise treatment.


Assuntos
Terapia Cognitivo-Comportamental , Transtorno Obsessivo-Compulsivo , Pessoal Técnico de Saúde , Humanos , Transtorno Obsessivo-Compulsivo/terapia , Autoeficácia , Resultado do Tratamento
7.
FP Essent ; 495: 17-22, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32757562

RESUMO

Obsessive-compulsive disorder (OCD) is characterized by recurrent intrusive thoughts, images, or urges (ie, obsessions) and repetitive mental acts or behaviors (ie, compulsions). Body dysmorphic disorder (BDD) is a chronic preoccupation with perceived flaws in physical appearance that leads to repetitive behaviors (ie, rituals). The Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) places both disorders under a new category, obsessive-compulsive and related disorders, along with hoarding disorder, excoriation disorder, and trichotillomania. Both OCD and BDD cause marked distress and functional impairment in patients. They share similarities in terms of risk factors and comorbid conditions. Management of these disorders involves a thorough assessment of symptoms, suicidal ideation, and comorbid medical and mental health conditions. Cognitive behavioral therapy (CBT) is the most effective therapy option for OCD. Pharmacotherapy with selective serotonin reuptake inhibitors (SSRIs) can be added for patients who do not improve with CBT only, or used as an initial treatment with or without CBT for patients with severe symptoms. For patients with BDD, initial treatments for monotherapy or combination therapy are SSRIs and/or CBT tailored to BDD. For patients with severe BDD or signs of suicidality, combination therapy should be used.


Assuntos
Transtornos Dismórficos Corporais , Transtorno Obsessivo-Compulsivo , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/terapia , Terapia Cognitivo-Comportamental , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/terapia
8.
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
9.
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
10.
Rev Med Liege ; 75(5-6): 426-431, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-32496692

RESUMO

Recent technological advances have seen the resumption or the advent of new approaches in the field of psychiatry such as electroconvulsive therapy, repeated transcranial magnetic stimulation, transcranial direct current electrical stimulation or even deep brain stimulation. These new approaches offer a window into the understanding of the neurobiological mechanisms linked to mental illnesses. This review summarizes current knowledges in the field and the future directions for the treatment of depression or obsessive-compulsive disorder.


Assuntos
Estimulação Encefálica Profunda , Transtorno Obsessivo-Compulsivo , Psiquiatria , Estimulação Transcraniana por Corrente Contínua , Estimulação Magnética Transcraniana , Humanos , Transtorno Obsessivo-Compulsivo/terapia , Psiquiatria/tendências
13.
J Clin Psychiatry ; 81(3)2020 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-32459406

RESUMO

OBJECTIVE: To evaluate efficacy, effect on mood, and safety of deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) at different target sites. DATA SOURCES: Electronic records from databases MEDLINE, EMBASE, and CENTRAL up to November 2019 were searched. Search terms included OCD, depression, and DBS. STUDY SELECTION: Eight randomized controlled trials (RCTs) (n = 85) and 38 observational studies (case reports and case series) (n = 225) were included. DATA EXTRACTION: In RCTs, the differences in outcomes between sham and active stimulation for OCD and depression were evaluated and the proportion of responders was determined. In all included studies, at last follow-up, the improvement from baseline in OCD (Yale-Brown Obsessive Compulsive Scale [Y-BOCS score]) and a scale of weighted depression scores (WDS) were determined. Predictors of response (age, illness duration and severity, frequency parameters, and response in depression) were evaluated. The proportions of adverse events and dropouts were calculated. RESULTS: In RCTs, mean differences between sham and active stimulation in Y-BOCS and Hamilton Depression Rating Scale (HDRS) scores were -7.8 (95% CI = -11.2 to -4.3, I² = 40%, P = .0001) and -7.3 (95% CI = -11.5 to -3.0, I² = 0%, P = .0009), respectively. No differences between limbic and non-limbic targets were identified (χ² = 0.21, I² = 0%, P = .0006). At last follow-up, improvements in Y-BOCS and WDS were -15.0 (95% CI = -18.3 to -11.7, I² = 90%, P < .001) and -13.7 (95% CI = -20.1 to -7.3, I² = 76%, P < .001), respectively. No consistent predictors of response were found. There were 0.68 adverse events (95% CI = 0.59 to 0.78, I² = 88%), 0.32 serious adverse events (95% CI = 0.12 to 0.62, I² = 96%), and 0.13 dropouts (95% CI = 0.07 to 0.16, I² = 16%) per treated patient. CONCLUSIONS: DBS can significantly decrease Y-BOCS score and depressive symptoms in refractory OCD.


Assuntos
Afeto , Estimulação Encefálica Profunda , Transtorno Obsessivo-Compulsivo/terapia , Estimulação Encefálica Profunda/métodos , Humanos , Transtorno Obsessivo-Compulsivo/psicologia , Resultado do Tratamento
14.
Fortschr Neurol Psychiatr ; 88(6): 398-401, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32380556

RESUMO

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


Assuntos
Ritmo Gama , Transtorno Obsessivo-Compulsivo/fisiopatologia , Transtorno Obsessivo-Compulsivo/terapia , Ritmo alfa , Depressão/complicações , Depressão/fisiopatologia , Depressão/psicologia , Depressão/terapia , Humanos , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/psicologia
15.
Brain Stimul ; 13(3): 858-860, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32289717

RESUMO

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


Assuntos
Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/terapia , Esquizofrenia/diagnóstico , Esquizofrenia/terapia , Estimulação Transcraniana por Corrente Contínua/métodos , Comorbidade , Feminino , Humanos , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/complicações , Esquizofrenia/complicações , Resultado do Tratamento
16.
Cancer Radiother ; 24(2): 166-173, 2020 Apr.
Artigo em Francês | MEDLINE | ID: mdl-32220562

RESUMO

Stereotactic radiosurgery (SRS) is a non-invasive technique that enables to create brain focal lesions with a high precision and localization. Thus, functional brain disorders can be treated by SRS in case of pharmacoresistance or inoperability. To date, treatment of trigeminal neuralgia is the most described and known indication. Other indications will be developed in the future like movement disorders, refractory epilepsy, obsessive compulsive disorder and severe depression. We present here a review of actual and future indications of functional brain SRS with their level of evidence. All these SRS treatments have to be strictly conducted by trained teams with an excellent collaboration between radiation physicists, medical physicists, neurosurgeons, neurologists, psychiatrists and probably neuroradiologists.


Assuntos
Epilepsia/radioterapia , Radiocirurgia/métodos , Tremor/radioterapia , Neuralgia do Trigêmeo/radioterapia , Transtorno Depressivo Maior/terapia , Epilepsia/etiologia , Humanos , Transtorno Obsessivo-Compulsivo/terapia , Doença de Parkinson/complicações , Doença de Parkinson/radioterapia , Radiocirurgia/efeitos adversos , Radiocirurgia/tendências , Dosagem Radioterapêutica , Esclerose/complicações , Resultado do Tratamento , Tremor/etiologia , Neuralgia do Trigêmeo/diagnóstico por imagem
17.
Ann Acad Med Singap ; 49(1): 15-25, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32200393

RESUMO

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


Assuntos
Transtorno Depressivo Maior , Transtorno Obsessivo-Compulsivo , Aceitação pelo Paciente de Cuidados de Saúde , Qualidade de Vida , Adolescente , Adulto , Comorbidade , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/terapia , Razão de Chances , Singapura/epidemiologia , Apoio Social , Ideação Suicida
18.
Curr Psychiatry Rep ; 22(4): 17, 2020 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-32076845

RESUMO

PURPOSE OF REVIEW: This review describes imagery rescripting (ImRs) and its clinical application to anxiety disorders and obsessive-compulsive disorder (OCD). Variations in ImRs delivery, clinical evidence, and theories of potential mechanisms of change are also reviewed. Finally, we propose a future research agenda. RECENT FINDINGS: There is some evidence that ImRs affects memory processes and schemas. ImRs is associated with reductions in cognitive-affective, physiological and behavioural symptoms of social anxiety disorder and reductions in OCD-related distress and OCD symptoms. ImRs for other anxiety disorders has not been evaluated. While ImRs appears to be an effective intervention for social anxiety disorder and OCD, more research is needed to (a) systematically compare ImRs to established interventions, (b) evaluate ImRs for other anxiety disorders, (c) test theorized mechanisms of change, and (d) evaluate the impact of moderating factors and treatment variations on therapeutic outcomes.


Assuntos
Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Imagens, Psicoterapia , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Cognição , Humanos , Memória
19.
Depress Anxiety ; 37(5): 418-428, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32048376

RESUMO

OBJECTIVE: Many therapists are reluctant to conduct exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD). Negative beliefs about the safety and tolerability of ERP are common, especially for harm-related OCD symptoms. The study examined the nature and frequency of ERP-related serious negative consequences (SNC) and therapist attitudes and experiences providing ERP for harm-related OCD. METHODS: An anonymous survey was completed by 277 therapists with experience treating OCD using ERP. Questions assessed clinical experiences of harm-related exposures, the nature of SNC, and concerns and clinical considerations regarding ERP. RESULTS: Therapist's willingness to treat harm-related OCD was high. SNCs were reported for 6 clients (per-client risk: adults 0.05%, youth 0.01%) and 13 therapists (per therapist risk 4.73%, therapist per-year risk 0.004%). Qualitative analysis identified themes relating to the conduct of treatment, specific exposure types, professional issues, and negative perceptions of ERP. CONCLUSION: SNC associated with ERP for OCD are rare and primarily represent unintended secondary consequences of OCD or misunderstandings regarding the process and rationale behind ERP. Improving access to ERP will require good communication with clients, families, and other professionals regarding the rationale and safety of ERP.


Assuntos
Competência Clínica , Terapia Cognitivo-Comportamental/métodos , Conhecimentos, Atitudes e Prática em Saúde , Terapia Implosiva/métodos , Transtorno Obsessivo-Compulsivo/terapia , Adolescente , Adulto , Atitude , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/psicologia , Relações Médico-Paciente , Inquéritos e Questionários , Resultado do Tratamento
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