TRANSTORNO OBSESSIVO-COMPULSIVO: LIMITES DIAGNOSTICOS

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Neste trabalho, descrevemos os resultados de nossos estudos sobre os limites internos (subtipos) e externos (fronteiras) do transtorno obsessivo-compulsivo (TOC)
fontenelle9.jpg Autor:
Leonardo Fontenelle,
Columnista Experto de SIIC

Institución:


Artículos publicados por Leonardo Fontenelle,
Recepción del artículo
22 de Marzo, 2004
Primera edición
17 de Junio, 2004
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Diversos estudos têm enfatizado a heterogeneidade clínica e prognóstica do transtorno obsessivo-compulsivo (TOC). Neste trabalho, descrevemos os resultados de nossos estudos sobre os limites internos (subtipos) e externos (fronteiras) do TOC. Pudemos constatar a existência de is subgrupos do TOC baseados, por exemplo, no gênero, na idade de início, na presença de acumulação e de transtornos de controle dos impulsos e, finalmente, na resposta favorável ao tratamento farmacológico. As fronteiras do TOC com os transtornos de controle dos impulsos, da imagem corporal, e alguns transtornos neurológicos (considerados por alguns pesquisadores como parte de um hipotético "espectro obsessivo-compulsivo"), são tênues e devem ser reavaliadas. Nós descrevemos casos de pacientes que repousam sobre esses limites virtuais e discutimos algumas limitações. Em síntese, nossos trabalhos apoiam a visão do TOC como uma rede de síndromes heterogêneas que só recentemente começa a ter sua complexidade desvendada.

Palabras clave
Transtorno obsessivo-compulsivo, psicopatologia, fenótipos, diagnóstico, comportamento impulsivo


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Abstract
Several studies have emphasized the clinical and prognostic heterogeneity of obsessive-compulsive disorder (OCD). In this article, we describe the results of several of our studies about the internal (subtypes) and external (frontiers) of OCD. We were able to identify some potential subtypes based on gender, age of onset, presence of hoarding and impulsive control disorders; and on the presence of favorable treatment response. OCD has tenuous frontiers with impulse control disorders, body image disorders and some neurological disorders (which belong to the so-called obsessive-compulsive spectrum). We describe cases of patients that seem to be within those virtual limits and suggest that their validity may need to be reassessed. In synthesis, our work supports the view of OCD as a net of heterogeneous syndromes that, only recently, has begun to have its complexity fully disentangled.

Key words
Obsessive-compulsive disorder, psychopathology, phenotypes, diagnosis, impulsive behavior


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Farmacología, Salud Mental
Relacionadas: Atención Primaria, Medicina Farmacéutica, Medicina Interna, Neurología



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Fontenelle, Leonardo
Bibliografía del artículo
  1. Coryell W. Obsessive-compulsive disorder and primary unipolar depression. Comparisons of background, family history, course, and mortality. J Nerv Ment Dis. 1981;169(4):220-4.
  2. Rudin E. Ein Beitrag zur Frage der Zwangskrankheit insebesondere ihrere hereditaren Beziehugen. Arch Psychiatr Nervenkr. 1953; 191: 4-54.
  3. Rasmussen SA, Eisen JL. Epidemiology of obsessive compulsive disorder.J Clin Psychiatry. 1990;51 Suppl:10-3.
  4. Stein MB, Forde DR, Anderson G, Walker JR. Obsessive-compulsive disorder in the community: an epidemiologic survey with clinical reappraisal. Am J Psychiatry. 1997;154(8):1120-6.
  5. Koran LM. Quality of life in obsessive-compulsive disorder. Psychiatr Clin North Am. 2000;23(3):509-17.
  6. DuPont RL, Rice DP, Shiraki S, Rowland CR. Economic costs of obsessive-compulsive disorder. Med Interface. 1995;8(4):102-9.
  7. Castle DJ, Groves A. The internal and external boundaries of obsessive-compulsive disorder.Aust N Z J Psychiatry. 2000;34(2):249-55.
  8. Stein DJ. Carving Nature at Its Joints: Different Approaches to the Obsessive-Compulsive Spectrum of Disorders. In: Obsessive-Compulsive Disorder. Maj M, Sartorius N, Okasha A, Zohar J, editors. Chinchester: John Wiley & Sons Ltd, 2000. p. 241-4.
  9. World Health Organization. The ICD-10 Classification of Mental and Behavioral. Clinical Descriptions and Diagnostic Guidelines, Geneva, World Health Organization, 1993.
  10. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Washington, American Psychiatric Association, 1994.
  11. Mataix-Cols D, Baer L, Rauch SL, Jenike MA. Relation of factor-analyzed symptom dimensions of obsessive-compulsive disorder to personality disorders. Acta Psychiatr Scand. 2000;102(3):199-202.
  12. Mataix-Cols D, Marks IM, Greist JH, Kobak KA, Baer L. Obsessive-compulsive symptom dimensions as predictors of compliance with and response to behaviour therapy: results from a controlled trial. Psychother Psychosom. 2002;71(5):255-62.
  13. Mataix-Cols D, Rauch SL, Baer L, Eisen JL, Shera DM, Goodman WK, Rasmussen SA, Jenike MA. Symptom stability in adult obsessive-compulsive disorder: data from a naturalistic two-year follow-up study. Am J Psychiatry. 2002;159(2):263-8.
  14. Mataix-Cols D, Rauch SL, Manzo PA, Jenike MA, Baer L. Use of factor-analyzed symptom dimensions to predict outcome with serotonin reuptake inhibitors and placebo in the treatment of obsessive-compulsive disorder. Am J Psychiatry. 1999;156(9):1409-16.
  15. Miguel EC, Baer L, Coffey BJ, Rauch SL, Savage CR, O'Sullivan RL, Phillips K, Moretti C, Leckman JF, Jenike MA. Phenomenological differences appearing with repetitive behaviours in obsessive-compulsive disorder and Gilles de la Tourette's syndrome. Br J Psychiatry. 1997;170:140-5.
  16. Perugi G, Akiskal HS, Gemignani A, Pfanner C, Presta S, Milanfranchi A, Lensi P, Ravagli S, Maremmani I, Cassano GB. Episodic course in obsessive-compulsive disorder. Eur Arch Psychiatry Clin Neurosci. 1998;248(5):240-4.
  17. Ravizza L, Maina G, Bogetto F. Episodic and chronic obsessive-compulsive disorder. Depress Anxiety. 1997;6(4):154-8.
  18. Fontenelle LF, Marques C, Versiani M. The effect of gender on the clinical features and therapeutic response in obsessive-compulsive disorder. Rev Bras Psiquiatr, 24 (1): 7-11, 2002.
  19. Fontenelle LF, Mendlowicz MV, Marques C, Versiani M. Early- and Late-Onset Obsessive-Compulsive Disorder In Adult Patients: An Exploratory Clinical And Therapeutic Study. J Psychiatr Res. 2003;37(2):127-33.
  20. Fontenelle LF, Mendlowicz MV, Soares ID, Versiani M. Patients with Obsessive-Compulsive Disorder and Hoarding Symptoms: A Distinct Subtype Compr Psychiatry (in press).
  21. Fontenelle LF, Mendlowicz MV, Marques C, Versiani M. Transcultural Aspects of Obsessive-Compulsive Disorder: A Description of a Brazilian Sample and a Systematic Review of International Clinical Studies. J Psychiatr Res (in press).
  22. Mathew SJ, Coplan JD, Perko KA, Goetz RR, de la Neuz M, Hollander E, Liebowitz MR, Fallon BA. Neuroendocrine predictors of response to intravenous clomipramine therapy for refractory obsessive-compulsive disorder. Depress Anxiety. 2001;14(4):199-208.
  23. Monteleone P, Catapano F, Di Martino S, Ferraro C, Maj M. Prolactin response to d-fenfluramine in obsessive-compulsive patients, and outcome of fluvoxamine treatment. Br J Psychiatry. 1997;170:554-7.
  24. Rauch SL, Shin LM, Dougherty DD, Alpert NM, Fischman AJ, Jenike MA. Predictors of fluvoxamine response in contamination-related obsessive compulsive disorder: a PET symptom provocation study. Neuropsychopharmacology. 2002;27(5):782-91.
  25. Saxena S, Brody AL, Ho ML, Zohrabi N, Maidment KM, Baxter LR Jr. Differential brain metabolic predictors of response to paroxetine in obsessive-compulsive disorder versus major depression. Am J Psychiatry. 2003;160(3):522-32.
  26. Brody AL, Saxena S, Schwartz JM, Stoessel PW, Maidment K, Phelps ME, Baxter LR Jr. FDG-PET predictors of response to behavioral therapy and pharmacotherapy in obsessive compulsive disorder. Psychiatry Res. 1998 9;84(1):1-6.
  27. Fontenelle L, Marques C, Engelhardt E, Versiani M. Impaired Set-Shifting Ability and Therapeutic Response In Obsessive-Compulsive Disorder. J Neuropsychiatry Clin Neurosci 2001;13(4):508-10.
  28. Fontenelle LF, Piedade RA, Ribeiro P, Mendlowicz MV, Kalaf J, Versiani M. Low-Resolution Electromagnetic Tomography and Treatment Response in obsessive-compulsive disorder. Biol Psychiatry Suppl (in press).
  29. Hollander E, Wong CM. Obsessive-compulsive spectrum disorders. J Clin Psychiatry. 1995;56 Suppl 4:3-6.
  30. Hollander E. Obsessive-compulsive disorder: the hidden epidemic. J Clin Psychiatry. 1997;58 Suppl 12:3-6.
  31. Rasmussen SA. Obsessive compulsive spectrum disorders. J Clin Psychiatry. 1994;55(3):89-91.
  32. Swerdlow NR. Blurry Spectrum Disorders. In: Obsessive-Compulsive Disorder. Maj M, Sartorius N, Okasha A, Zohar J, editors. Chinchester: John Wiley & Sons Ltd, 2000. p. 235-8.
  33. Fontenelle LF, Mendlowicz M, Marques C, Mussi TC, Versiani M. The Man With the Purple Nostrils: A Case of Rhinotrichotillomania Secondary to Body Dismorphic Disorder. Acta Psychiatr Scand. 2002;190(9):643-6.
  34. Fontenelle LF, Mendlowicz MV, Menezes GB, Marques C, Versiani M. Asperger Syndrome and Obsessive-Compulsive Disorder in a Patient with a 45,X/46,XY Mosaicism: Case Report. Psychopathology (in press).
  35. Fontenelle LF, Cordás TA, Sassi E. Eating disorders and their relationship to mood and obsessive-compulsive spectrum disorders. Rev Bras Psiquiatr. 2002; 24(Supl III): 24-8.
  36. Fontenelle LF, Mendlowicz MV, Menezes GB, Appolinário JC, Godoy-Matos, A, Versiani M, Comparison of Symptom Profile of Obese Binge Eaters, Obese Non-Binge Eaters and Patients with Obsessive-Compulsive Disorder. J Nerv Ment Dis. 2002;106(6):464-6.

 
 
 
 
 
 
 
 
 
 
 
 
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