Obsessive-compulsive disorder: conceptual and clinical aspects
Transtorno obsessivo-compulsivo: aspectos conceituais e clínicos
Palavras-chave:
Transtorno obsessivo-compulsivo, TOC, Diagnóstico, Tratamento, PrevençãoResumo
Obsessive-compulsive disorder (OCD) is a chronic, prevalent, and disabling psychiatric disorder that affects people of all ages and may have been worsened by the COVID-19 pandemic. This study aims to review conceptual and clinical aspects of OCD, including its history, diagnosis, symptom dimensions, etiology, assessment, prevention, and treatment. The history of OCD shows the transition from religious to medical conceptions. The main symptoms of OCD involve the presence of obsessive thoughts and compulsive acts, which can manifest themselves in four dimensions: ‘contamination and cleanliness’, ‘order and symmetry’, ‘doubt and verification’, and ‘disgusting thoughts and mental rituals’. This heterogeneity in the manifestation of OCD can make it difficult to understand its causes and to compare treatment responses. OCD management involves symptom assessment; prevention through psychoeducation and reducing family accommodation; pharmacological and psychotherapeutic treatment. First-line treatments involves the administration of serotonin reuptake inhibitor drugs and/or cognitive-behavioral therapy, with exposure and ritual avoidance techniques, and cognitive reappraisal.
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Abramovitch, A., Short, T., & Schweiger, A. (2021). The C Factor: Cognitive dysfunction as a transdiagnostic dimension in psychopathology. Clinical Psychology Review, 86, 102007. doi:10.1016/j.cpr.2021.102007
Abramowitz, J. S., & Jacoby, R. J. (2015). Obsessive-compulsive and related disorders: A critical review of the new diagnostic class. Annual Review of Clinical Psychology, 11, pp. 165-186. doi:10.1146/annurev-clinpsy-032813-153713
Abramowitz, J. S., Deacon, B. J., Olatunji, B. O., Wheaton, M. G., Berman, N. C., Losardo, D., . . . Hale, L. R. (2010). Assessment of obsessive-compulsive symptom dimensions: Development and evaluation of the Dimensional Obsessive-Compulsive Scale. Psychological Assessment, 22(1), 180-198. doi:10.1037/a0018260
Albert, U., Marazziti, D., Di Salvo, G., Solia, F., Rosso, G., & Maina, G. (2018). A systematic review of evidence-based treatment strategies for obsessive-compulsive disorder resistant to first-line pharmacotherapy. Current Medicinal Chemistry, 25(41), pp. 5647-5661. doi:10.2174/0929867325666171222163645
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders: DSM-III (3 ed.). Washington: American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5 ed.). Arlington: American Psychiatric Association.
Araújo, A. C., & Lotufo-Neto, F. (2014). A nova classifcação americana para os transtornos mentais – o DSM-5. Revista Brasileira de Terapia Comportamental e Cognitiva, 16(1), 67-82.
Bokor, G., & Anderson, P. D. (2014). Obsessive-compulsive disorder. Journal of Pharmacy Practice, 27(2), 116-130. doi:10.1177/0897190014521996
Brakoulias, V., Perkes, I. E., & Tsalamanios, E. (2018). A call for prevention and early intervention in obsessive-compulsive disorder. Early Intervention in Psychiatry, , 12(4), pp. 572-577. doi:10.1111/eip.12535
Cordioli, A. V. (2014). O TOC e as suas manifestações. Em A. V. Cordioli, Manual de Terapia Cognitivo-Comportamental para o Transtorno Obsessivo-Compulsivo (2ª ed., pp. 13-32). Porto Alegre: Artmed.
Cordioli, A. V., Vivian, A. S., & Braga, D. T. (2017). Vencendo o transtorno obsessivo-compulsivo: manual de terapia cognitivo-comportamental para pacientes e terapeutas (3 ed.). Porto Alegre: Artmed.
Fineberg, N. A., Dell'Osso, B., Albert, U., Maina, G., Geller, D., Carmi, L., . . . Zohar, J. (2019). Early intervention for obsessive compulsive disorder: An expert consensus statement. European Neuropsychopharmacology, 29(4), pp. 549-565. doi:10.1016/j.euroneuro.2019.02.002
Foa, E. (2010). Cognitive behavioral therapy of obsessive-compulsive disorder. Dialogues in Clinical Neuroscience, 12(2), pp. 199-207.
Fornaro, M., Gabrielli, F., Albano, C., Fornaro, S., Rizzato, S., Mattei, C., . . . Fornaro, P. (2009). Obsessive-compulsive disorder and related disorders: A comprehensive survey. Annals of General Psychiatry, 8, 1-13. doi:10.1186/1744-859X-8-13
Franklin, M. E., Abramowitz, J. S., Kozak, M. J., Levitt, J. T., & Foa, E. B. (2000). Effectiveness of exposure and ritual prevention for obsessive-compulsive disorder: randomized compared with nonrandomized samples. Journal of Consulting and Clinical Psychology, 68(4), pp. 594-602.
Goodman, W. K., Grice, D. E., Lapidus, K. A., & Coffey, B. J. (2014). Obsessive-compulsive disorder. Psychiatric Clinics of North America, 37(3), 257-267. doi:10.1016/j.psc.2014.06.004
Grados, M. A. (2003). Obsessive-compulsive disorder after traumatic brain injury. International Review of Psychiatry, 15(4), pp. 350-358. doi:10.1080/09540260310001606737
Greist, J. H., Bandelow, B., Hollander, E., Marazziti, D., Montgomery, S. A., Nutt, D. J., . . . Anxiety, W. C. (2003). WCA recommendations for the long-term treatment of obsessive-compulsive disorder in adults. CNS Spectrums, 8(1), pp. 7-16. doi:10.1017/s1092852900006908
Hirschtritt, M. E., Bloch, M. H., & Mathews, C. A. (2017). Obsessive-compulsive disorder advances in diagnosis and treatment. JAMA - Journal of the American Medical Association, 317(13), 1358-1367. doi:10.1001/jama.2017.2200
Kashyap, H., & Abramovitch, A. (2021). Neuropsychological research in obsessive-compulsive disorder: current status and future directions. Frontiers in Psychiatry, 12. doi:10.3389/fpsyt.2021.721601
Koran, L. M., Hanna, G. L., Hollander, E., Nestadt, G., Simpson, H. B., & Association, A. P. (2007). Practice guideline for the treatment of patients with obsessive-compulsive disorder. The American Journal of Psychiatry,, 164(7), pp. 5-53.
Lebowitz, E. R., Panza, K. E., Su, J., & Bloch, M. H. (2012). Family accommodation in obsessive-compulsive disorder. Expert Review of Neurotherapeutics, 12(2), pp. 229-238. doi:10.1586/ern.11.200
Mahjani, B., Bey, K., Boberg, J., & Burton, C. (2021). Genetics of obsessive-compulsive disorder. Psychological Medicine, 51(13), pp. 2247-2259. doi:10.1017/S0033291721001744
Mataix-Cols, D., Rosario-Campos, M. C., & Leckman, J. F. (2005). Amultidimensional model of obsessive-compulsive disorder. AmericanJournal of Psychiatry, 162, 228-238.
Moheb, N., Charuworn, K., Ashla, M. M., Desarzant, R., Chavez, D., & Mendez, M. F. (2019). Repetitive behaviors in frontotemporal dementia: compulsions or impulsions? The Journal of Neuropsychiatry and Clinical Neurosciences, 31(2), pp. 132-136. doi:10.1176/appi.neuropsych.18060148
Molano-Eslava, J. C., Iragorri-Cucalón, A., Ucrós-Rodríguez, G., Bonilla-Jácome, C., Tovar-Perdomo, S., Herin, D. V., & Orozco-Cabal, L. (2008). Obsessive-Compulsive disorder symptoms in Huntington's disease: a case report. Revista Colombiana de Psiquiatria, 37(4), pp. 644-654. doi:10.1901/jaba.2008.37-644
Mroczkowski, M. M., Goes, F. S., Riddle, M. A., Grados, M. A., Bienvenu, O. J., Greenberg, B. D., . . . Samuels, J. F. (2011). Separation anxiety disorder in OCD. Depression and Anxiety, 28(3), pp. 256-262. doi:10.1002/da.20773
Nur, N. S., & Harun, M. (2019). Variation in neoplasm in relation with production of different types of obsession and compulsion. Cancer Clinics Journal, 1(1005), pp. 16-18.
Ornell, F., Braga, D. T., Bavaresco, D. V., Francke, I. D., Scherer, J. N., von Diemen, L., & Kessler, F. (2021). Obsessive-compulsive disorder reinforcement during the COVID-19 pandemic. Trends in Psychiatry and Psychotherapy, 43(2), pp. 81-84. doi:10.47626/2237-6089-2020-0054
Öst, L. G., Havnen, A., Hansen, B., & Kvale, G. (2015). Cognitive behavioral treatments of obsessive-compulsive disorder. A systematic review and meta-analysis of studies published 1993-2014. Clinical Psychology Review, 40, pp. 156-169. doi:10.1016/j.cpr.2015.06.003
Öst, L. G., Riise, E. N., Wergeland, G. J., Hansen, B., & Kvale, G. (2016). Cognitive behavioral and pharmacological treatments of OCD in children: A systematic review and meta-analysis. Journal of Anxiety Disorders, 43, pp. 58-69. doi:10.1016/j.janxdis.2016.08.003
Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35(9), pp. 793-802. doi:10.1016/s0005-7967(97)00040-5
Rapp, A. M., Bergman, R. L., Piacentini, J., & McGuire, J. F. (2016). Evidence-based assessment of obsessive-compulsive disorder. Journal of central nervous system disease, 8, pp. 13-19. doi:10.4137/JCNSD.S38359
Richter, P., & Ramos, R. T. (2018). Obsessive-Compulsive Disorder. Continuum (Minneapolis, Minn.), 24(3, BEHAVIORAL NEUROLOGY AND PSYCHIATRY), 828–844. doi:10.1212/CON.0000000000000603
Rosso, G., Albert, U., Asinari, G. F., Bogetto, F., & Maina, G. (2012). Stressful life events and obsessive-compulsive disorder: clinical features and symptom dimensions. Psychiatry Research, 197(3), pp. 259-264. doi:10.1016/j.psychres.2011.10.005
Salkovskis, P. M., Forrester, E., & Richards, C. (1998). Cognitive-behavioural approach to understanding obsessional thinking. The British Journal of Psychiatry, Supplement (35), pp. 53-63.
Soomro, G. M., Altman, D., Rajagopal, S., & Oakley-Browne, M. (2008). Selective serotonin re-uptake inhibitors (SSRIs) versus placebo for obsessive compulsive disorder (OCD). Cochrane Database of Systematic Reviews, 1. doi:10.1002/14651858.CD001765.pub3
Stein, D. J., Costa, D. L., Lochner, C., Miguel, E. C., Reddy, Y. C., Shavitt, R. G., . . . Simpson, H. B. (2019). Obsessive–compulsive disorder. Nature Reviews Disease Primers, 5(1), 1-46. doi:10.1038/s41572-019-0102-3
Swedo, S. E., Leonard, H. L., & Rapoport, J. L. (2004). The pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) subgroup: separating fact from fiction. Pediatrics, 113(4), pp. 907-911. doi:10.1542/peds.113.4.907
Swedo, S. E., Rapoport, J. L., Cheslow, D. L., Leonard, H. L., Ayoub, E. M., Hosier, D. M., & Wald, E. R. (1989). High prevalence of obsessive-compulsive symptoms in patients with Sydenham's chorea. The American Journal of Psychiatry, 146(2), pp. 246-249. doi:10.1176/ajp.146.2.246
Uhre, C. F., Uhre, V. F., Lønfeldt, N. N., Pretzmann, L., Vangkilde, S., Plessen, K. J., . . . Pagsberg, A. K. (2020). Systematic review and meta-analysis: Cognitive-behavioral therapy for obsessive-compulsive disorder in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 59(1), pp. 64-77. doi:10.1016/j.jaac.2019.08.480
Veale, D., & Roberts, A. (2014). Obsessive-compulsive disorder. BMJ (Online), 348, 1-6. doi:10.1136/bmj.g2183
Wheaton, M. G., Galfalvy, H., Steinman, S. A., Wall, M. M., Foa, E. B., & Simpson, H. B. (2016). Patient adherence and treatment outcome with exposure and response prevention for OCD: Which components of adherence matter and who becomes well? Behaviour Research and Therapy, 85, pp. 6-12. doi:10.1016/j.brat.2016.07.010
Wootton, B. M. (2016). Remote cognitive-behavior therapy for obsessive-compulsive symptoms: A meta-analysis. Clinical psychology review,, 43, pp. 103-113. doi:10.1016/j.cpr.2015.10.001