Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.690
Filtrar
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
2.
Rev Prat ; 70(5): 496-501, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-33058633

RESUMO

When should we use antidepressant medications in children? Antidepressant medication may not be considered as a first-line treatment in children; psychotherapeutic treatments should always be preferentially used. At this age, the efficacy of SSRI is regarded as low to moderate for depression, but moderate to high for Obsessive Compulsive Disorder (OCD) and anxiety disorders. When an antidepressant medication is prescribed, a SSRI should always be used first. In particular, fluoxetine is the most studied SSRI and the only medication who received approval by the French regulatory authority. Sertraline and fluvoxamine which have been approved for OCD should preferentially be used for that purpose. During the first 4 weeks, clinicians should actively monitor the onset of side effects, especially mood swings and suicidal behavior. The onset or increase of suicidal thoughts during SSRI treatment would concern about 1 out of 100 young patients treated. This risk is maximal during the first four weeks following the introduction of the SSRI and should progressively decrease after one month. When used in children, antidepressant medication can only be used in association with psychotherapeutic treatments and psychosocial interventions targeting the maintaining factors perpetuating the cycle of affective symptoms.


Assuntos
Antidepressivos , Transtorno Obsessivo-Compulsivo , Antidepressivos/uso terapêutico , Transtornos de Ansiedade , Criança , Humanos , Transtornos do Humor , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Psicotrópicos
4.
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
5.
Nord J Psychiatry ; 74(7): 461-469, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32242450

RESUMO

Background: Obsessive-compulsive disorder (OCD) is a common psychiatric illness in children and adolescents. Previous evidence suggests that fluoxetine is effective in the treatment of OCD in children and adolescents. However, those studies had small sample sizes. As a result, a systematic review, which is a more powerful method to calculate the true effect size, can be applied to examine the efficacy, acceptability and tolerability of fluoxetine in the treatment of OCD in children and adolescents.Objectives: The aims of this study were to review the efficacy, acceptability and tolerability of fluoxetine in the treatment of OCD in children and adolescents.Study appraisal and synthesis methods: The titles and abstracts collected from electronic databases were evaluated. Then, the full-text versions of relevant studies were thoroughly assessed and extracted.Results: A total of 188 randomized patients in three RCTs of fluoxetine versus placebo and one RCT of fluoxetine versus citalopram were included in this review. Considering efficacious outcomes, the pooled mean change score of the CY-BOCS in the fluoxetine-treated group was significantly greater than that in the placebo-treated group. Additionally, the CGI-S in the fluoxetine-treated group and the pooled mean change score of the NIMH-OC were also significantly different from those in the placebo-treated group.Limitation: This review included studies with small sample sizes.Conclusions and implications of key findings: Fluoxetine is associated with a significantly greater reduction in OCD severity, as measured by the CY-BOCS, NIMH-OC and CGI-S, in children and adolescents. Additionally, it is well tolerated in children and adolescents. The acceptability is comparable to that of the placebo-treated group. Nonetheless, further large prospective trials should be conducted to confirm these outcomes.


Assuntos
Fluoxetina , Transtorno Obsessivo-Compulsivo , Adolescente , Criança , Citalopram , Fluoxetina/uso terapêutico , Humanos , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Estudos Prospectivos , Projetos de Pesquisa , Resultado do Tratamento
6.
Can J Physiol Pharmacol ; 98(4): 236-242, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32228235

RESUMO

Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder, of unknown etiology, that affects 2.5% of the population. An appropriate therapeutic response to conventional treatment is seen. Some studies use augmentative treatment by antipsychotics, glutamatergic, lithium, buspirone, and others agents to improve the therapeutic response. In this study, we aimed to evaluate the efficacy and tolerability of aripiprazole and quetiapine as augmentative treatments in patients with selective serotonin reuptake inhibitor (SSRI) refractory OCD. The OCD patients were initially treated for 12 weeks with a SSRI. If after 12 weeks their Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score was more than 16, they were randomly assigned to either the aripiprazole or the quetiapine augmentation group for an additional 12 weeks. There were no significant differences in age, sex, education, marital status, or score of Y-BOCS and Clinical Global Impression-Severity Scale (CGI-S) between groups (p > 0.05) at the outset of the study. Significant differences were noted after 1 month when compared with results at 2, 3, and 4 months in both groups (p < 0.001). Both quetiapine and aripiprazole may be effective and well-tolerated augmentative agents in the treatment of SSRI-refractory OCD. Because of positive results, aripiprazole may be considered more effective and may have a more rapid onset in terms of therapeutic response.


Assuntos
Antipsicóticos/uso terapêutico , Aripiprazol/uso terapêutico , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Fumarato de Quetiapina/uso terapêutico , Inibidores de Captação de Serotonina/uso terapêutico , Serotonina/metabolismo , Adulto , Quimioterapia Combinada/métodos , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/metabolismo , Método Simples-Cego
7.
Psychopharmacology (Berl) ; 237(7): 1973-1987, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32313981

RESUMO

RATIONALE: Obsessive-compulsive disorder (OCD) is characterized by repetitive behaviors exacerbated by stress. Many OCD patients do not respond to available pharmacotherapies, but neurosurgical ablation of the anterior cingulate cortex (ACC) can provide symptomatic relief. Although the ACC receives noradrenergic innervation and expresses adrenergic receptors (ARs), the involvement of norepinephrine (NE) in OCD has not been investigated. OBJECTIVE: To determine the effects of genetic or pharmacological disruption of NE neurotransmission on marble burying (MB) and nestlet shredding (NS), two animal models of OCD. METHODS: We assessed NE-deficient (Dbh -/-) mice and NE-competent (Dbh +/-) controls in MB and NS tasks. We also measured the effects of anti-adrenergic drugs on NS and MB in control mice and the effects of pharmacological restoration of central NE in Dbh -/- mice. Finally, we compared c-fos induction in the locus coeruleus (LC) and ACC of Dbh -/- and control mice following both tasks. RESULTS: Dbh -/- mice virtually lacked MB and NS behaviors seen in control mice but did not differ in the elevated zero maze (EZM) model of general anxiety-like behavior. Pharmacological restoration of central NE synthesis in Dbh -/- mice completely rescued NS behavior, while NS and MB were suppressed in control mice by anti-adrenergic drugs. Expression of c-fos in the ACC was attenuated in Dbh -/- mice after MB and NS. CONCLUSION: These findings support a role for NE transmission to the ACC in the expression of stress-induced compulsive behaviors and suggest further evaluation of anti-adrenergic drugs for OCD is warranted.


Assuntos
Comportamento Compulsivo/metabolismo , Modelos Animais de Doenças , Norepinefrina/metabolismo , Transtorno Obsessivo-Compulsivo/metabolismo , Estresse Psicológico/metabolismo , Antagonistas de Receptores Adrenérgicos alfa 1/farmacologia , Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico , Animais , Comportamento Compulsivo/tratamento farmacológico , Comportamento Compulsivo/psicologia , Feminino , Masculino , Camundongos , Camundongos da Linhagem 129 , Camundongos Endogâmicos C57BL , Camundongos Knockout , Norepinefrina/antagonistas & inibidores , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Transtorno Obsessivo-Compulsivo/psicologia , Receptores Adrenérgicos/metabolismo , Roedores , Estresse Psicológico/tratamento farmacológico , Estresse Psicológico/psicologia
8.
Int. j. clin. health psychol. (Internet) ; 20(1): 20-28, ene.-abr. 2020. graf, tab
Artigo em Inglês | IBECS | ID: ibc-198904

RESUMO

BACKGROUND/OBJECTIVE: The main aim of this study was to analyze differences in inhibition and cognitive flexibility, taking into account some variables that may influence results (non verbal reasoning, depression, anxiety, intolerance of uncertainty, comorbidity, medication consumption). METHOD: The participants were 95 adults aged 17-61 years old (M = 33.48, SD = 11.13), primary (most severe) Generalized Anxiety Disorder or Obsessive-Compulsive Disorder and a healthy control group. Neuropsychological neasures were completed using computerized Wisconsin Card Sorting Test, Stroop Color Word Test and Go/NoGo Task. RESULTS: Clinical groups presented worse results in cognitive flexibility to the control group. The obsessive-compulsive group showed worse scores in flexibility than the generalized anxiety group, once non-verbal reasoning and tolerance to uncertainty were controlled. Comorbidity and medication use did not affect results in the obsessive compulsive group but did however influence the generalized anxiety group. CONCLUSIONS: Cognitive flexibility could be included treatment in the treatment of obsessive-compulsive disorder and generalized anxiety disorder


ANTECEDENTES/OBJETIVO: El objetivo de este estudio fue analizar las diferencias en flexibilidad cognitiva e inhibición de respuestas teniendo en cuenta algunas variables que pueden influir en los resultados (razonamiento no verbal, depresión, ansiedad, intolerancia a la incertidumbre, comorbilidad, consumo de fármacos). MÉTODO: Los participantes fueron 95 adultos de edades comprendidas entre 17-61 años (M = 33,48; DT = 11,13), diagnosticados de Trastorno obsesivo-compulsivo, Trastorno de ansiedad generalizada y un grupo de control sano. Las variables neuropsicológicas fueron evaluadas con el Test de Clasificación de Tarjetas de Wisconsin, Test Stroop de Colores y Palabras y Tareas Go/NoGo. RESULTADOS: Los grupos clínicos presentaron peores resultados en flexibilidad cognitiva frente al grupo control. El grupo obsesivo-compulsivo alcanzó peores puntuaciones en flexibilidad que el grupo con ansiedad generalizada, una vez controlado el razonamiento no verbal y la tolerancia a la incertidumbre. La comorbilidad y el consumo de fármacos no afectaron a los resultados en el grupo obsesivo-compulsivo. Sin embargo, ambas variables influyeron en el grupo con ansiedad generalizada. CONCLUSIONES: La flexibilidad cognitiva podría ser incluida en los paquetes de tratamiento del Trastorno obsesivo-compulsivo y del Trastorno de ansiedad generalizada


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/psicologia , Transtornos de Ansiedade/psicologia , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Transtornos de Ansiedade/tratamento farmacológico , Diagnóstico Duplo (Psiquiatria) , Incerteza , Testes Neuropsicológicos , Fatores Socioeconômicos , Análise de Variância
9.
Phytother Res ; 34(8): 1889-1901, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32124509

RESUMO

Obsessive-compulsive disorder (OCD) is a relatively prevalent mental disorder that poses significant health burdens on the community. Although current conventional medications have good efficacy for many patients, they can elicit a range of associated adverse effects. Plant-based compounds have been evaluated for different mental disorders, with a range of anxiolytic properties revealed. To determine the current evidence in the area, we conducted a systematic review using the electronic databases including PubMed, Scopus, and the Cochrane Library up to June 12, 2019, for pharmacological and clinical evidence of herbal medicines and phytochemicals with antiobsessive-compulsive effects. Additional search criteria were employed for locating research on the underpinning mechanisms of action. Results revealed that tentative low-quality evidence exists for several plant medicines, including Crocus sativus, Silybum marianum, Echium amoenum, Hypericum perforatum, and Withania somnifera, along with several natural molecules, including crocin, cannabidiol, and curcumin. Although more research is needed to confirm effectiveness, present preclinical studies indicate that monoamine pathway modulation (in particular serotonin reuptake inhibition) may be the most important anti-OCD mechanism among the studied natural compounds.


Assuntos
Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Fitoterapia/métodos , Plantas Medicinais/química , Humanos
10.
Rev. psiquiatr. infanto-juv ; 37(1): 29-33, ene.-mar. 2020.
Artigo em Espanhol | IBECS | ID: ibc-193562

RESUMO

El Trastorno obsesivo-compulsivo constituye una patología grave e incapacitante. El tratamiento de primera línea no consigue una remisión completa en casi la mitad de los pacientes. En adultos se ha demostrado la utilidad del tratamiento coadyuvante con aripiprazol en estos casos. En adolescentes la evidencia al respecto es escasa, aunque se han publicado algunos resultados prometedores. Tampoco se dispone de evidencia suficiente sobre la eficacia y seguridad de los antipsicóticos inyectables de liberación prolongada en población adolescente, por lo que sólo se recomiendan en trastornos psicóticos con respuesta insuficiente por falta de adherencia. Sin embargo, algunos autores proponen extender su utilización a otras patologías. Se presenta el caso de una paciente adolescente con trastorno obsesivocompulsivo resistente al tratamiento de primera línea, en la que la utilización coadyuvante de aripiprazol inyectable de liberación prolongada permite un buen control de la clínica obsesiva y contribuye a evitar nuevas descompensaciones


Obsessive-compulsive disorder is a severe and disabling pathology. First-line treatment does not achieve full remission in almost half of patients. In adults, the efficacy of the adjuvant treatment with aripiprazole has been demonstrated in these cases. There is not enough evidence in the adolescent population, although some promising results have been published. Scant evidence is available on the efficacy and safety of long-acting injectable antipsychotics in adolescents. Their use is recommended only in psychotic disorders with insufficient response due to lack of adherence. However, some authors suggest their use in other pathologies. The case of an adolescent patient with obsessive-compulsive disorder resistant to first-line treatment is presented. The adjuvant use of long-acting injectable aripiprazole allows for good control of the obsessive symptoms and helps prevent future episodes


Assuntos
Humanos , Feminino , Adolescente , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Aripiprazol/administração & dosagem , Sertralina/administração & dosagem , Preparações de Ação Retardada/farmacocinética , Injeções Intramusculares/métodos , Aripiprazol/farmacocinética , Sertralina/farmacocinética , Exacerbação dos Sintomas
11.
J Altern Complement Med ; 26(5): 398-408, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32073874

RESUMO

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


Assuntos
Transtorno Depressivo/tratamento farmacológico , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Preparações de Plantas/uso terapêutico , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Viola , Adolescente , Adulto , Transtorno Depressivo/complicações , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/complicações , Projetos Piloto , Distúrbios do Início e da Manutenção do Sono/etiologia , Inquéritos e Questionários , Adulto Jovem
15.
Pediatrics ; 145(2)2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32015180

RESUMO

Phenotypic and biological characterization of rare monogenic disorders represents 1 of the most important avenues toward understanding the mechanisms of human disease. Among patients with SH3 and multiple ankyrin repeat domains 3 (SHANK3) mutations, a subset will manifest neurologic regression, psychosis, and mood disorders. However, which patients will be affected, when, and why are important unresolved questions. Authors of recent studies suggest neuronal SHANK3 expression is modulated by both inflammatory and hormonal stimuli. In this case series, we describe 4 independent clinical observations of an immunotherapy responsive phenotype of peripubertal-onset neuropsychiatric regression in 4 girls with pathogenic SHANK3 mutations. Each child exhibited a history of stable, mild-to-moderate lifelong developmental disability until 12 to 14 years of age, at which time each manifested a similar, subacute-onset neurobehavioral syndrome. Symptoms included mutism, hallucinations, insomnia, inconsolable crying, obsessive-compulsive behaviors, loss of self-care, and urinary retention and/or incontinence. Symptoms were relatively refractory to antipsychotic medication but improved after immunomodulatory treatment. All 4 patients exhibited chronic relapsing courses during a period of treatment and follow-up ranging from 3 to 6 years. Two of the 4 girls recovered their premorbid level of functioning. We briefly review the scientific literature to offer a conceptual and molecular framework for understanding these clinical observations. Future clinical and translational investigations in this realm may offer insights into mechanisms and therapies bridging immune function and human behavior.


Assuntos
Transtorno do Espectro Autista/genética , Deficiências do Desenvolvimento/genética , Mutação da Fase de Leitura , Imunoterapia/métodos , Proteínas do Tecido Nervoso/genética , Comportamento Estereotipado , Adolescente , Agressão/efeitos dos fármacos , Antipsicóticos/uso terapêutico , Ansiedade , Catatonia/tratamento farmacológico , Criança , Comportamento Compulsivo/tratamento farmacológico , Choro , Feminino , Alucinações/tratamento farmacológico , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Imunossupressores/uso terapêutico , Humor Irritável/efeitos dos fármacos , Metilprednisolona/uso terapêutico , Mutismo/tratamento farmacológico , Fármacos Neuroprotetores/uso terapêutico , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Recidiva , Autocuidado , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Comportamento Estereotipado/efeitos dos fármacos , Síndrome , Incontinência Urinária , Retenção Urinária
17.
J Pharmacol Toxicol Methods ; 102: 106676, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31954839

RESUMO

Object burying by rodents is a popular screening tool for anxiolytic agents. However, modulation of marble-burying by serotonin reuptake inhibitors prompted its link to obsessive-compulsive disorder/compulsive-like behavior. The Marble-burying behavior test is an acute test; however, some investigators incorporate the sub-acute treatment regimen as an essential component for screening anti-compulsive agents. The test exhibits between-laboratory methodological differences and demonstrates positive treatment responses to an array of pharmacotherapies, creating doubts about its predictive validity and construct validity. Numerous reviews are available on marble-burying behavior test, which incorporates the test as a part of anti-compulsive behavior-like screens, but none has made it a sole subject-matter for discussion. This review attempts to provide a comprehensive account of the marble-burying test as a model of compulsive-like disorders. It envisages the model's scientific origins, the preclinical research done and its correlation with the clinical research outcomes, and a detailed discussion about its validity. In conclusion, there appears a need to address the issue of construct and predictive validity of the model authoritatively; or the paradigm may remain squandered in the field of obsessive-compulsive disorder research.


Assuntos
Comportamento Animal/fisiologia , Modelos Animais de Doenças , Transtorno Obsessivo-Compulsivo/fisiopatologia , Animais , Ansiolíticos/farmacologia , Escala de Avaliação Comportamental , Comportamento Animal/efeitos dos fármacos , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Roedores , Inibidores de Captação de Serotonina/farmacologia
18.
Clin Neurophysiol ; 131(3): 716-724, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32000072

RESUMO

OBJECTIVE: This study aimed to identify an Electroencephalography (EEG) complexity biomarker that could predict treatment resistance in Obsessive compulsive disorder (OCD) patients. Additionally, the statistical differences between EEG complexity values in treatment-resistant and treatment-responsive patients were determined. Moreover, the existence of correlations between EEG complexity and Yale-Brown Obsessive Compulsive Scale (YBOCS) score were evaluated. METHODS: EEG data for 29 treatment-resistant and 28 treatment-responsive OCD patients were retrospectively evaluated. Approximate entropy (ApEn) method was used to extract the EEG complexity from both whole EEG data and filtered EEG data, according to 4 common frequency bands, namely delta, theta, alpha, and beta. The random forests method was used to classify ApEn complexity. RESULTS: ApEn complexity extracted from beta band EEG segments discriminated treatment-responsive and treatment-resistant OCD patients with an accuracy of 89.66% (sensitivity: 89.44%; specificity: 90.64%). Beta band EEG complexity was lower in the treatment-resistant patients and the severity of OCD, as measured by YBOCS score, was inversely correlated with complexity values. CONCLUSIONS: The results indicate that, EEG complexity could be considered a biomarker for predicting treatment response in OCD patients. SIGNIFICANCE: The prediction of treatment response in OCD patients might help clinicians devise and administer individualized treatment plans.


Assuntos
Encéfalo/fisiopatologia , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Transtorno Obsessivo-Compulsivo/fisiopatologia , Inibidores de Captação de Serotonina/uso terapêutico , Adolescente , Adulto , Biomarcadores , Eletroencefalografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Estudos Retrospectivos , Falha de Tratamento , Adulto Jovem
19.
Ann Clin Psychiatry ; 32(1): 42-47, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31990968

RESUMO

BACKGROUND: Obsessive-compulsive disorder (OCD) is difficult to treat. Studies have shown associations of white matter pathology in OCD, as well as various other psychiatric illnesses, using diffusion tensor imaging (DTI). We conducted a systematic review of controlled studies on drugnaïve patients with OCD vs pharmacologically treated patients with OCD to examine whether pharmacotherapy exerts changes on white matter in OCD. METHODS: A search was conducted to identify controlled trials published from January 2010 to July 2018. All studies used DTI to assess for white matter volume in drug-naïve patients with OCD, pharmacologically treated patients with OCD, and healthy controls. RESULTS: Three studies met the criteria for inclusion. The findings of one study suggest that selective serotonin reuptake inhibitors do exert some changes on white matter, some of which appear to reverse abnormalities noted in the fronto-striato-thalamo-cortical pathways. In another study, no differences in white matter parameters were found between drug-naïve patients vs healthy controls. In a third study, high fractional anisotropy in the splenium correlated with a greater severity of OCD. CONCLUSIONS: Our systematic review suggests mixed results regarding whether drug-naïve patients with OCD have a difference in white matter compared with pharmacologically treated patients with OCD, and whether patients with OCD have a difference in white matter compared with healthy controls.


Assuntos
Imagem de Tensor de Difusão , Transtorno Obsessivo-Compulsivo/diagnóstico por imagem , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Substância Branca/efeitos dos fármacos , Substância Branca/diagnóstico por imagem , Humanos
20.
Expert Opin Pharmacother ; 21(2): 163-165, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31893946

RESUMO

Introduction: Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterized by obsessions and compulsions. Obsessions are defined as intrusive, recurrent and distressing thoughts, images or impulses, whereas compulsions are defined as repetitive behaviors or mental acts. While there is an associated distress, and indeed oftentimes, the individual's awareness that these behaviors are excessive and unreasonable, the individual continues to be disabled by an inability to cease their compulsions. The postpartum period may herald the onset of OCD or precipitate an exacerbation of the preexisting OCD symptoms. Common OCD symptom clusters occur in the postpartum period, with specific challenges associated with motherhood and lactation.Areas covered: This brief review aims to review the extent and nature of publications evaluating pharmacological treatment of OCD in the postpartum period.Expert opinion: Education and training should aim to improve the recognition and treatment of postpartum OCD. Due to the limited nature of studies, more research is required to assess the role of selective serotonin reuptake inhibitors in the postpartum period.


Assuntos
Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Período Pós-Parto , Aleitamento Materno , Comportamento Compulsivo/tratamento farmacológico , Feminino , Humanos , Transtorno Obsessivo-Compulsivo/psicologia , Inibidores de Captação de Serotonina/uso terapêutico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...