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Características clínicas y respuesta al tratamiento en el trastorno obsesivo-compulsivo con poca y con buena conciencia de enfermedad

Published online by Cambridge University Press:  12 May 2020

V. Ravi Kishore
Affiliation:
Departamento de Psiquiatría, Instituto Nacional de Salud Mental y Neuwciencias (NIMHANS), Bangalore 560029, Estado de Kamataka, India
R. Samar
Affiliation:
Departamento de Psiquiatría, Instituto Nacional de Salud Mental y Neuwciencias (NIMHANS), Bangalore 560029, Estado de Kamataka, India
Y. C. Janardhan Reddy
Affiliation:
Departamento de Psiquiatría, Instituto Nacional de Salud Mental y Neuwciencias (NIMHANS), Bangalore 560029, Estado de Kamataka, India
C. R. Chandrasekhar
Affiliation:
Departamento de Psiquiatría, Instituto Nacional de Salud Mental y Neuwciencias (NIMHANS), Bangalore 560029, Estado de Kamataka, India
K. Thennarasu
Affiliation:
Departamento de Psiquiatría, Instituto Nacional de Salud Mental y Neuwciencias (NIMHANS), Bangalore 560029, Estado de Kamataka, India
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Resumen

Los criterios del DSM-IV reconocen la existencia del trastorno obsesivo-compulsivo (TOC) con poca conciencia de enfermedad. Sin embargo, hay una escasez de publicaciones sobre los correlatos clínicos y la respuesta al tratamiento en TOC con poca conciencia de enfermedad y con buena conciencia de enfermedad. En este estudio, la conciencia de enfermedad se mide utilizando la Escala de Evaluación de las Creencias de Brown (BABS) desarrollada específicamente para evaluar la conciencia de enfermedad. Se comprobó a cien sujetos con TOC del DSM-IV de la clínica de TOC de un gran hospital psiquiátrico en India. Todos los sujetos recibieron una evaluación arnplia utilizando instrumentos estructurados y medidas establecidas de trastornos psicopatológicos. Se trató a los sujetos con dosis adecuadas de fármacos durante un periodo adecuado. Los resultados mostraron que el 25% de los sujetos tenían poca conciencia de enfermedad. La poca conciencia de enfermedad se asociaba con edad anterior en el comienzo, duración más larga de la enfermedad, mayor número de síntomas obsesivo-compulsivos, enfermedad más grave y tasa más alta de comorbilidad, particularmente de depresión mayor. De los sujetos que recibieron tratamiento adecuado (n = 73), 44 (el 60%) respondieron al tratamiento. La poca conciencia de enfermedad se asociaba con mala respuesta al tratamiento farmacológico. En el análisis de regresión logística paso a paso, la puntuación de la BABS en la línea de base predecía muy bien la mala respuesta al tratamiento. La poca conciencia de enfermedad parece asociarse con correlatos clínicos específicos y mala respuesta al tratamiento farmacológico. Se necesitan más estudios en muestras mayores para replicar nuestros hallazgos.

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 2004

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References

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Características clínicas y respuesta al tratamiento en el trastorno obsesivo-compulsivo con poca y con buena conciencia de enfermedad
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