Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 61
Filtrar
Mais filtros

País/Região como assunto
Intervalo de ano de publicação
1.
Aust N Z J Psychiatry ; 57(1): 130-139, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35303769

RESUMO

BACKGROUND: The obsession of turning into another person (transformation obsessions [TO]), and its related compulsions have been initially conceptualised as a form of mental contamination. Nevertheless, it has remained understudied in the current obsessive-compulsive disorder (OCD) literature. In parallel, disturbances of the self have been identified as markers of prodromal psychosis in patients with schizophrenia. Based on the later association, this study aimed to investigate the sociodemographic and clinical correlates of TO. METHODS: In all, 1001 OCD outpatients from the Brazilian OCD Research Consortium were included in this study. Several semi-structured and structured instruments were used to compare 48 OCD patients with TO with 953 OCD patients without TO. A repression model investigated the relationships between the presence of current TO and statistically significant univariate test outcomes. RESULTS: Participants with TO presented an overall younger age, a longer period of time between the onset of the OCD symptoms and an OCD diagnosis, greater severity of the sexual/religious dimension and increased suicidality symptoms. CONCLUSIONS: These results indicate that TO may be better conceptualised as a form of forbidden/taboo thoughts rather than contamination. While no significant associations with psychotic features (e.g. decreased insight) were observed, TO patients displayed increased suicidality, overall younger age and a significantly larger disparity between seeking treatment and OCD diagnosis. This demonstrates that further clinical awareness and research into TO as an OCD symptom is most needed.


Assuntos
Transtorno Obsessivo-Compulsivo , Humanos , Transtorno Obsessivo-Compulsivo/diagnóstico , Comportamento Compulsivo , Comportamento Obsessivo , Psicopatologia , Ideação Suicida
2.
Clin Psychol Psychother ; 30(6): 1520-1533, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37554049

RESUMO

INTRODUCTION: Mental rituals (MR) are compulsions with no overt behavioural or motoric signs. It is presently unclear whether MR found in obsessive-compulsive disorder are associated with a distinctive clinical profile. OBJECTIVES: The main objectives of this paper were to assess the prevalence and psychopathological correlates of mental rituals in a large sample of OCD patients. METHODS: This exploratory case-control study compared 519 patients with versus 447 without MR in terms of sociodemographics, presence and severity of obsessive-compulsive symptoms, psychiatric comorbidities, sensory phenomena, suicidality, and insight. RESULTS: Current MR were found in 51.8%, while lifetime MR were found in 55.4% of the sample. The multiple logistic regression model determined that the most relevant clinical factors independently associated with current MR in OCD patients were the absence of any sensory phenomena and the presence of lifetime suicide ideation. CONCLUSION: Due to its relation to OCD clinical aspects, MR are a frequent feature among OCD patients. It also seems to be associated with a range of features that are probably relevant for treatment, especially sensory phenomena and suicidality.


Assuntos
Comportamento Ritualístico , Transtorno Obsessivo-Compulsivo , Humanos , Prevalência , Estudos de Casos e Controles , Transtorno Obsessivo-Compulsivo/psicologia , Comportamento Compulsivo/epidemiologia , Comportamento Compulsivo/psicologia
3.
Psychol Med ; 52(4): 715-725, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-32669156

RESUMO

BACKGROUND: Patients with obsessive-compulsive disorder (OCD) are at increased risk for suicide attempt (SA) compared to the general population. However, the significant risk factors for SA in this population remains unclear - whether these factors are associated with the disorder itself or related to extrinsic factors, such as comorbidities and sociodemographic variables. This study aimed to identify predictors of SA in OCD patients using a machine learning algorithm. METHODS: A total of 959 outpatients with OCD were included. An elastic net model was performed to recognize the predictors of SA among OCD patients, using clinical and sociodemographic variables. RESULTS: The prevalence of SA in our sample was 10.8%. Relevant predictors of SA founded by the elastic net algorithm were the following: previous suicide planning, previous suicide thoughts, lifetime depressive episode, and intermittent explosive disorder. Our elastic net model had a good performance and found an area under the curve of 0.95. CONCLUSIONS: This is the first study to evaluate risk factors for SA among OCD patients using machine learning algorithms. Our results demonstrate an accurate risk algorithm can be created using clinical and sociodemographic variables. All aspects of suicidal phenomena need to be carefully investigated by clinicians in every evaluation of OCD patients. Particular attention should be given to comorbidity with depressive symptoms.


Assuntos
Transtorno Obsessivo-Compulsivo , Tentativa de Suicídio , Comorbidade , Humanos , Aprendizado de Máquina , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia , Prevalência , Ideação Suicida
4.
Braz J Psychiatry ; 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38573616

RESUMO

OBJECTIVE: This study aims to evaluate the effectiveness of online group cognitive-behavioral therapy (GCBT) guided by the CAMALEO TOC manual in treating of adolescents with obsessive compulsive disorder (OCD). METHOD: A quasi-experimental study with a single group pre-posttest intervention. Over 12 weeks 11 adolescents aged 11 to 17 years with OCD received weekly online sessions of GCBT based on CAMALEO TOC manual. The Children's Yale-Brown Obsessive-Compulsive Scale was used to assess OCD symptoms severity, the Family accommodation scale for obsessive-compulsive disorder interviewer-rated for family accommodation, the Children's Depression Inventory to assess depression symptoms, the Revised Children's Manifest Anxiety Scale for anxiety, and the Multidimensional Student Life Satisfaction Scale to assess life satisfaction. RESULTS: OCD symptoms decreased significantly (d = -1.55). A strong effect size (d = -1.03) was also found for family accommodation. No significant difference in OCD symptoms and family accommodation scores were found when controlling for differences between being in psychotherapeutic treatment, medication use, or psychiatric comorbidities. There was also no evidence that the intervention was effective in reducing symptoms of depression, anxiety or improving quality of life. CONCLUSION: We demonstrate the feasibility of a short-term online GCBT as an effective treatment for adolescents with OCD.

5.
Trends Psychiatry Psychother ; 45: e20210370, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35244353

RESUMO

INTRODUCTION: Although post-traumatic stress disorder and obsessive-compulsive disorder have distinct diagnostic criteria, some psychopathological phenomena seem to be shared, which may lead to misdiagnosis and erroneous treatment decisions. This scoping review explores the psychopathological similarities and differences between these two disorders. METHOD: The review complies with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and included articles published in Portuguese, English, or Spanish in the last 50 years indexed in the PubMed database. Case-reports were excluded. RESULTS: Fifty-three studies with different designs were included (30 [56.5%] were cross-sectional studies; eight [15.1%] were case-control studies; one [1.9%] was a cohort study; three [5.7%] were clinical trials; nine [17%] were reviews/systematic reviews; and two [3.8%] were meta-analyses). The main psychopathological aspects described by the studies included were flashbacks x obsessions; avoidant behavior (AB); depressive, anxious, and somatic symptoms; sexuality, sleep, and appetite; psychiatric comorbidities; and suicidality. The intersection between clinical features seems to occur in the extrinsic psychopathological dimension. CONCLUSION: The disorders' core psychopathological symptoms (intrinsic characteristics) are distinctly different, since flashbacks and obsessions are consequences of different predominant defective mental functions: the former derives from defective memory, the latter from defective thought. Along the same lines, the ABs observed in the two disorders are products of different purposes and inner necessities.


Assuntos
Transtorno Obsessivo-Compulsivo , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Estudos de Coortes , Transtorno Obsessivo-Compulsivo/psicologia , Psicopatologia , Comorbidade
6.
Braz J Psychiatry ; 45(2): 146-161, 2023 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-36749887

RESUMO

OBJECTIVES: To summarize evidence-based pharmacological treatments and provide guidance on clinical interventions for adult patients with obsessive-compulsive disorder (OCD). METHODS: The American Psychiatric Association (APA) guidelines for the treatment of OCD (2013) were updated with a systematic review assessing the efficacy of pharmacological treatments for adult OCD, comprising monotherapy with selective serotonin reuptake inhibitors (SSRIs), clomipramine, serotonin and norepinephrine reuptake inhibitors (SNRIs), and augmentation strategies with clomipramine, antipsychotics, and glutamate-modulating agents. We searched for the literature published from 2013-2020 in five databases, considering the design of the study, primary outcome measures, types of publication, and language. Selected articles had their quality assessed with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association (ACC/AHA). RESULTS: We examined 57 new studies to update the 2013 APA guidelines. High-quality evidence supports SSRIs for first-line pharmacological treatment of OCD. Moreover, augmentation of SSRIs with antipsychotics (risperidone, aripiprazole) is the most evidence-based pharmacological intervention for SSRI-resistant OCD. CONCLUSION: SSRIs, in the highest recommended or tolerable doses for 8-12 weeks, remain the first-line treatment for adult OCD. Optimal augmentation strategies for SSRI-resistant OCD include low doses of risperidone or aripiprazole. Pharmacological treatments considered ineffective or potentially harmful, such as monotherapy with antipsychotics or augmentation with ketamine, lamotrigine, or N-acetylcysteine, have also been detailed.


Assuntos
Antipsicóticos , Transtorno Obsessivo-Compulsivo , Humanos , Adulto , Antipsicóticos/uso terapêutico , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Clomipramina/uso terapêutico , Aripiprazol/uso terapêutico , Risperidona , Brasil , Resultado do Tratamento , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Transtorno Obsessivo-Compulsivo/psicologia
7.
Braz J Psychiatry ; 2023 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-37718254

RESUMO

OBJECTIVE: To summarize the evidence-based cognitive-behavioral therapy (CBT) treatment and propose clinical interventions for adult patients with obsessive-compulsive disorder (OCD). METHODS: A systematic review of the literature on CBT interventions for the treatment of adult OCD, comprising behavior therapy and exposure and response prevention (ERP) was done. The objective of this study is to present updated clinical guidelines to clinicians, providing comprehensive details regarding the necessary procedures to be incorporated into the CBT protocol. We searched the literature published from 2013-2020 in five databases (PubMed, Cochrane, Embase, Psycinfo and Lilacs), considering: study design, primary outcome measures, type of publication and language. Selected articles were assessed for quality with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association (ACC/AHA). RESULTS: We examined 44 new studies used to update the APA guidelines from 2013. High-quality evidence supports CBT including ERP techniques as the first-line CBT treatment for OCD. In addition, protocols for internet-delivered CBT have also demonstrated their efficacy for the treatment of adults with OCD. CONCLUSION: CBT based on ERP is a widely used treatment according to high-quality scientific evidence to treat adults with OCD.

8.
Psychiatry Res ; 197(3): 253-8, 2012 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-22361443

RESUMO

A substantial number of patients with obsessive-compulsive disorder (OCD) report compulsions that are preceded not by obsessions but by subjective experiences known as sensory phenomena. This study aimed to investigate the frequency, severity, and age at onset of sensory phenomena in OCD, as well as to compare OCD patients with and without sensory phenomena in terms of clinical characteristics. We assessed 1,001 consecutive OCD patients, using instruments designed to evaluate the frequency/severity of OC symptoms, tics, anxiety, depression, level of insight and presence/severity of sensory phenomena. All together, 651 (65.0%) subjects reported at least one type of sensory phenomena preceding the repetitive behaviors. Considering the sensory phenomena subtypes, 371 (57.0%) patients had musculoskeletal sensations, 519 (79.7%) had externally triggered "just-right" perceptions, 176 (27.0%) presented internally triggered "just right," 144 (22.1%) had an "energy release," and 240 (36.9%) patients had an "urge only" phenomenon. Sensory phenomena were described as being as more severe than were obsessions by 102(15.7%) patients. Logistic regression analysis showed that the following characteristics were associated with the presence of sensory phenomena: higher frequency and greater severity of the symmetry/ordering/arranging and contamination/washing symptom dimensions; comorbid Tourette syndrome, and a family history of tic disorders. These data suggest that sensory phenomena constitute a poorly understood psychopathological aspect of OCD that merits further investigation.


Assuntos
Transtorno Obsessivo-Compulsivo/psicologia , Percepção , Transtornos de Tique/psicologia , Síndrome de Tourette/psicologia , Adolescente , Adulto , Idade de Início , Ansiedade/complicações , Ansiedade/tratamento farmacológico , Ansiedade/psicologia , Criança , Depressão/complicações , Depressão/tratamento farmacológico , Depressão/psicologia , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Transtornos de Tique/complicações , Transtornos de Tique/tratamento farmacológico , Síndrome de Tourette/complicações , Síndrome de Tourette/tratamento farmacológico
9.
Compr Psychiatry ; 53(5): 562-8, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22014580

RESUMO

The objective of this study was to compare patients with obsessive-compulsive disorder (OCD) associated with pathologic skin picking (PSP) and/or trichotillomania, and patients with OCD without such comorbidities, for demographic and clinical characteristics. We assessed 901 individuals with a primary diagnosis of OCD, using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I disorders. Diagnoses of PSP and trichotillomania were made in 16.3% and 4.9% of the sample, respectively. After the logistic regression analysis, the following factors retained an association with OCD-PSP/trichotillomania: younger (odds ratio [OR] = 0.979; P = .047), younger at the onset of compulsive symptoms (OR = 0.941; P = .007), woman (OR = 2.538; P < .001), with a higher level of education (OR = 1.055; P = .025), and with comorbid body dysmorphic disorder (OR = 2.363; P = .004). These findings support the idea that OCD accompanied by PSP/trichotillomania characterizes a specific subgroup.


Assuntos
Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Tricotilomania/epidemiologia , Adulto , Distribuição por Idade , Transtornos Dismórficos Corporais/epidemiologia , Brasil/epidemiologia , Estudos de Casos e Controles , Comorbidade , Estudos Transversais , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Educação , Feminino , Humanos , Modelos Logísticos , Masculino , Transtorno Obsessivo-Compulsivo/psicologia , Prevalência , Distribuição por Sexo , Tricotilomania/psicologia
10.
Psychiatry Res ; 312: 114567, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35490573

RESUMO

This study aimed to identify the factors associated with a delay in treatment-seeking among patients with obsessive-compulsive disorder (OCD), a disabling neuropsychiatric disorder. To achieve this purpose, we conducted a cross-sectional study examining latency to treatment (LTT) and its associated correlates in 863 patients with OCD. We defined LTT as the time lag between the awareness of discomfort and/or impairment caused by symptoms and the beginning of OCD-specific treatment. To determine the socio-demographic and clinical characteristics associated with LTT, we built an interval-censored survival model to simultaneously assess the relationship between all variables, representing the best fit to our data format. The results of our study showed that approximately one-third of OCD patients sought treatment within two years of symptom awareness, one-third between two and nine years, and one-third after ten or more years. Median LTT was 4.0 years (mean = 7.96, SD = 9.54). Longer LTT was associated with older age, early onset of OCD symptoms, presence of contamination/cleaning symptoms and full-time employment. Shorter LTT was associated with the presence of aggression symptoms and comorbidity with hypochondriasis. The results of our study confirm the understanding that LTT in OCD is influenced by several interdependent variables - some of which are modifiable. Strategies for reducing LTT should focus on older patients, who work in a full-time job, and on individuals with early onset of OCD and contamination/cleaning symptoms.


Assuntos
Transtorno Obsessivo-Compulsivo , Comorbidade , Estudos Transversais , Humanos , Hipocondríase/epidemiologia , Transtorno Obsessivo-Compulsivo/diagnóstico
11.
CNS Spectr ; 16(9): 179-89, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24725632

RESUMO

UNLABELLED: IntroductionThe dimensional approach of the obsessive-compulsive symptoms may help to find more homogeneous groups of patients. The brain derived neurotrophic factor (BDNF) may help to identify neurobiological differences between obsessive-compulsive symptom dimensions. METHODS: We compared serum BDNF (pg/µg) levels of 25 unmedicated patients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for obsessivecompulsive disorder (OCD) and 25 controls, using the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Yale-Brown Obsessive-Compulsive Scale and the Beck's Anxiety and Depression Inventories. RESULTS: There were no sociodemographic differences between the groups. The standard error of mean serum BDNF levels were reduced in unmedicated OCD patients (0.47+0.038) when compared to healthy controls (0.75+0.060) (P<.001). The patients with the presence of sex/religion obsessive-compulsive symptoms (OCS) dimension (P=.002), with chronic course of OCS (P=.022) and the presence of lifetime major depression (P=.016) and social anxiety (P=.030) presented higher levels of BDNF than OCD patients without those features. The severity of aggression (P=.039) and sex/religion (P<.001) OCS dimension presented direct (moderate and strong, respectively) correlation with serum BDNF levels in this sample. Serum BDNF levels were decreased in OCD patients when compared to healthy controls.Discussion/ConclusionSexual and religious content of symptoms and aggression and sex/religion dimensions severity should be better explored, since these specific OCS dimensions could be based on neurocircuits diverse from those of the other OCS dimensions.

12.
Trends Psychiatry Psychother ; 43(3): 200-206, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34852186

RESUMO

INTRODUCTION: Suicide is a serious public health problem that affects the whole world. This study describes development of the prototype for an mHealth application (app) intended to assist healthcare professionals to identify suicide risk in hospitalized patients and reports on testing of the app by some of these professionals, conducted to confirm its functionality. METHOD: This is applied exploratory research into use of Information Technology within the healthcare field, based on application prototyping for mobile devices. The research was conducted at the Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) from 2017 to 2019. Six healthcare professionals, one data scientist, and three undergraduate students in Biomedical Informatics took part in the study. All research participants signed the free and informed consent form. RESULTS: The main findings show that the development team created a prototype named Detect-S, which became a cross-platform application (iOS and Android) offering 16 functions. CONCLUSION: It can be concluded that Detect-S has the potential to be a positive technological instrument that can be tested in a hospital setting to assist healthcare professionals to identify and manage patients with at risk of suicide.


Assuntos
Aplicativos Móveis , Prevenção do Suicídio , Telemedicina , Pessoal de Saúde , Humanos
13.
Depress Anxiety ; 27(6): 528-55, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20533367

RESUMO

The obsessive-compulsive (OC) spectrum has been discussed in the literature for two decades. Proponents of this concept propose that certain disorders characterized by repetitive thoughts and/or behaviors are related to obsessive-compulsive disorder (OCD), and suggest that such disorders be grouped together in the same category (i.e. grouping, or "chapter") in DSM. This article addresses this topic and presents options and preliminary recommendations to be considered for DSM-V. The article builds upon and extends prior reviews of this topic that were prepared for and discussed at a DSM-V Research Planning Conference on Obsessive-Compulsive Spectrum Disorders held in 2006. Our preliminary recommendation is that an OC-spectrum grouping of disorders be included in DSM-V. Furthermore, we preliminarily recommend that consideration be given to including this group of disorders within a larger supraordinate category of "Anxiety and Obsessive-Compulsive Spectrum Disorders." These preliminary recommendations must be evaluated in light of recommendations for, and constraints upon, the overall structure of DSM-V.


Assuntos
Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtorno Obsessivo-Compulsivo/diagnóstico , Humanos
14.
Trends Psychiatry Psychother ; 42(3): 276-281, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32997043

RESUMO

INTRODUCTION: Suicide is an issue of great severity in public health worldwide. This study aimed to investigate which instruments are most frequently used by healthcare professionals to assess suicide risk and how accessible such instruments are, as well as to determine the scope of suicide phenomena. METHOD: A systematic review was performed using the following Boolean searches: "scale AND suicide," "evaluation AND suicide," "questionnaire AND suicide." The articles retrieved were read and selected by two independent researchers - any discrepancies were addressed by a third researcher. RESULTS: From a total number of 206 articles, 20 instruments were identified as being currently used to assess suicide risk. The two most common were the Beck Scale for Suicide Ideation (BSI) and The Columbia - Suicide Severity Rating Scale (C-SSRS). CONCLUSION: Even though the two scales (BSI and C-SSRS) are the most frequently mentioned and used by healthcare professionals to assess suicide risk, both instruments present breaches in their structure and there is not yet a single instrument considered to be the gold standard. As a future perspective, there is the urgency of developing a new tool that can widely and completely assess all psychopathological aspects of suicidality.


Assuntos
Escalas de Graduação Psiquiátrica/normas , Medição de Risco/métodos , Suicídio , Humanos , Ideação Suicida
15.
J Neuropsychiatry Clin Neurosci ; 21(4): 381-92, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19996246

RESUMO

A subgroup of obsessive-compulsive disorder (OCD) patients remains refractory to conventional treatments. For them, a new stereotactic radiosurgery has been recently developed: the ventral capsular/ventral striatal (VC/VS) gamma capsulotomy. The authors aim to report efficacy and adverse events of VC/VS gamma capsulotomy. Five refractory OCD patients were selected. The authors assessed OCD, anxiety and depressive symptoms, and side effects pre- and postoperatively. Three patients (60%) met response criteria 48 months after surgery. Adverse effects were episodic and transient. Ventral capsular/ventral striatal gamma capsulotomy holds therapeutic promise, with few adverse effects.


Assuntos
Gânglios da Base/cirurgia , Cápsula Interna/cirurgia , Transtorno Obsessivo-Compulsivo/cirurgia , Adulto , Feminino , Seguimentos , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Radiocirurgia , Resultado do Tratamento
16.
Psychiatry Res ; 170(1): 32-42, 2009 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-19801170

RESUMO

The question of whether Tourette's syndrome (TS) and trichotillomania (TTM) are best conceptualized as obsessive-compulsive spectrum disorders was raised by family studies demonstrating a close relationship between TS and obsessive-compulsive disorder (OCD), and by psychopharmacological research indicating that both TTM and OCD respond more robustly to clomipramine than to desipramine. A range of studies have subsequently allowed comparison of the phenomenology, psychobiology, and management of TS and TTM, with that of OCD. Here we briefly review this literature. The data indicate that there is significant psychobiological overlap between TS and OCD, supporting the idea that TS can be conceptualized as an OCD spectrum disorder. TTM and OCD have only partial overlap in their phenomenology and psychobiology, but there are a number of reasons for why it may be useful to classify TTM and other habit disorders as part of the obsessive-compulsive spectrum of disorders.


Assuntos
Transtorno Obsessivo-Compulsivo/diagnóstico , Síndrome de Tourette/diagnóstico , Tricotilomania/diagnóstico , Diagnóstico Diferencial , Progressão da Doença , Humanos , Transtorno Obsessivo-Compulsivo/genética , Transtorno Obsessivo-Compulsivo/terapia , Síndrome de Tourette/genética , Síndrome de Tourette/terapia , Tricotilomania/genética , Tricotilomania/terapia
17.
Compr Psychiatry ; 50(1): 63-9, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19059516

RESUMO

Previous studies have shown differences in clinical features of obsessive-compulsive disorder (OCD) between men and women, including mean age at onset of obsessive-compulsive symptoms (OCS), types of OCS, comorbid disorders, course, and prognosis. The aim of this study was to compare male and female Brazilian patients with OCD on several demographic and clinical characteristics. Three hundred thirty outpatients with OCD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV], criteria) who sought treatment at 3 Brazilian public universities and at 2 private practice clinics in the city of São Paulo were evaluated. The assessment instruments used were the Yale-Brown Obsessive-Compulsive Scale to evaluate OCD severity and symptoms, the Beck Depression and Anxiety Inventories, the Yale Global Tic Severity Scale, and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I Disorders to assess psychiatric comorbidity. Fifty-five percent of the patients (n = 182) were men who were significantly more likely than women to be single and to present sexual, religious, and symmetry obsessions and mental rituals. They also presented earlier onset of OCS and earlier symptom interference in functioning, and significantly more comorbid tic disorders and posttraumatic stress disorder. Women, besides showing significantly higher mean scores in the Beck Depression and Anxiety Inventories, were more likely to present comorbid simple phobias, eating disorders in general and anorexia in particular, impulse control disorders in general, and compulsive buying and skin picking in particular. No significant differences were observed between sexes concerning family history of OCS or OCD, and global symptoms severity, either in obsession or compulsive subscale. The present study confirms the presence of sex-related differences described in other countries and cultures. The fact that the OCS start earlier and probably have a worse impact in men can eventually lead to more specific and efficacious treatment approaches for these patients.


Assuntos
Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/genética , Fenótipo , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Área Programática de Saúde , Criança , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/diagnóstico , Projetos de Pesquisa , Fatores Sexuais , Inquéritos e Questionários , Adulto Jovem
18.
Eur Psychiatry ; 24(5): 297-306, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19200694

RESUMO

PURPOSE: To identify the presence of factors associated with treatment outcome in patients under group cognitive-behavioral therapy (GCBT) for obsessive-compulsive disorder (OCD). SUBJECTS AND METHODS: This study evaluated 181 patients with OCD that attended a 12-session weekly GCBT program. Response criteria were: >/=35% reduction in Y-BOCS scores and global improvement score of the Clinical Global Impression (CGI)

Assuntos
Terapia Cognitivo-Comportamental/métodos , Transtorno Obsessivo-Compulsivo/terapia , Psicoterapia de Grupo/métodos , Adulto , Fatores Etários , Conscientização , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/psicologia , Determinação da Personalidade/estatística & dados numéricos , Prognóstico , Psicometria , Fatores Sexuais , Resultado do Tratamento
19.
Front Psychiatry ; 10: 413, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31333508

RESUMO

Introduction: Insight may be defined as the ability to perceive and evaluate external reality and to separate it from its subjective aspects. It also refers to the ability to self-assess difficulties and personal qualities. Insight may be a predictor of success in the treatment of obsessive-compulsive disorder (OCD), so that individuals with poor insight tend to become refractory to treatment. The objective of this study is to investigate factors associated with poor insight in individuals with OCD. Methods: This cross-sectional exploratory study used the Brown Belief Assessment Scale as a parameter for the creation of the comparison groups: individuals who obtained null scores (zero) composed the group with preserved or good insight (n = 148), and those with scores above the 75% percentile composed the group with poor insight (n = 124); those with intermediate scores were excluded. Sociodemographic characteristics and clinical and psychopathological aspects, intrinsic and extrinsic to the typical symptoms of OCD, were compared in a univariate analysis. A logistic regression was used to determine which factors associated with critical judgment remained significant. Results: Individuals in the poor insight group differed from those with good insight in regard to: more prevalent use of neuroleptics (p = 0.05); higher untreated time interval (p < 0.001); higher total Yale-Brown obsessive-compulsive scale score and the obsessions and compulsions factors (all factors with p < 0.001); higher dimensional Yale-Brown obsessive-compulsive scale total and dimensional scores (p from 0.04 to 0.001); higher prevalence of contamination/cleaning (p = 0.006) and hoarding (p < 0.001) symptoms dimensions; more prevalent sensory phenomena (p = 0.023); higher levels of depression (p = 0.007); and more prevalent comorbidity with bipolar affective disorder (p = 0.05) and post-traumatic stress disorder (PTSD) (p = 0.04). After analyzing the logistic regression, we conclude that the most important factors associated with poor insight are: the presence of any sensory phenomena (OR: 2.24), use of neuroleptics (OR: 1.66), and hoarding symptoms (OR: 1.15). Conclusion: The variability of insight in patients with OCD seems to be an important psychopathological characteristic in the differentiation of possible subtypes of OCD, since the poor insight is associated with sensory phenomena and greater use of neuroleptics, which makes it possible to conjecture the role of dopaminergic neurocircuits in the neurobiology of this disorder. In addition, there is also an association with the symptoms of hoarding content, admittedly one of the symptomatic contents with less response to conventional OCD treatments. Studies based on neurobiological aspects such as neuroimaging and neuropsychology may help to elucidate more consistently the role of insight in patients with OCD and the repercussions concerning available treatments.

20.
Arq Bras Oftalmol ; 82(4): 336-338, 2019 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-31116317

RESUMO

Aniridia is a congenital eye disorder with a variable degree of hypoplasia or absence of iris tissue. It is caused by loss of function of the PAX6 gene and may be an isolated ocular abnormality or part of a syndrome. WAGRO refers to a rare genetic condition leading to Wilms tumor, aniridia, genitourinary anomalies, mental retardation, and obesity and is caused by a deletion of the short arm of chromosome 11 (11p), where the PAX6 gene is located. Here, we report on an 8-year-old boy with aniridia, polar cataract, and lens subluxation along with neuropsychomotor and speech delays. Karyotype evaluation showed an interstitial deletion including region 11p13-p14, confirming the diagnosis of WAGRO syndrome. In cases of aniridia, a diagnosis of WAGRO syndrome should be considered.


Assuntos
Aniridia/diagnóstico , Catarata/diagnóstico , Subluxação do Cristalino/diagnóstico , Obesidade/diagnóstico , Síndrome WAGR/diagnóstico , Aniridia/genética , Catarata/genética , Criança , Deleção Cromossômica , Cromossomos Humanos Par 11/genética , Humanos , Cariótipo , Subluxação do Cristalino/genética , Masculino , Obesidade/genética , Síndrome WAGR/genética
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA