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Diagnósticos psiquiátricos y rasgos de personalidad asociados con el deterioro de la capacidad de toma de decisiones
Published online by Cambridge University Press: 12 May 2020
Resumen
Objetivo.
El deterioro de la capacidad de toma de decisiones es un rasgo importante de los trastornos psiquiátricos. En una población numerosa con diversas enfermedades psiquiátricas exploramos la relación entre el deterioro de los procesos de toma de decisiones y las variables clínicas.
Métodos.
Usamos la Tarea de Apuestas de lowa (lowa Gambling Task) para medir la capacidad de toma de decisiones en 317 pacientes. Los diagnósticos psiquiátricos se hicieron siguiendo los criterios del DSM-IV. Se usaron autocuestionarios para evaluar varios rasgos de la personalidad. Se identificaron los últimos intentos suicidas y los más graves.
Resultados.
(1) Después de controlar la edad y la ingesta de medicación, un intento de suicidio anterior (CP = 2 [1,1-3,8]) y los trastornos bipolares normotímicos (CP = 3,4 [1,1-10,5]) se asociaron significativamente y por separado con el deterioro de los procesos de toma de decisiones. (2) La capacidad de toma de decisiones se correlacionó significativamente con la labilidad afectiva. (3) No se encontró ninguna asociación entre las capacidades para la toma de decisiones y las características suicidas.
Discusión.
Una falta de poder estadístico puede haber enmascarado las asociaciones con el trastorno obsesivo compulsivo y la anorexia nerviosa. No controlamos otras funciones cognitivas excepto la atención.
Conclusión.
Este estudio confirma la asociación independiente entre el deterioro de la capacidad de toma de decisiones y la vulnerabilidad a la conducta suicida, pero no con el abuso de sustancias. Los trastornos bipolares normotímicos, pero no los trastornos unipolares también se asociaron con el rendimiento bajo. A nivel dimensional, la impulsividad y las capacidades para la toma de decisiones pueden ser procesos distintos. La capacidad de regulación afectiva parece ejercer una influencia importante sobre el rendimiento en la toma de decisiones y, en consecuencia, es un objetivo terapéutico importante.
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- Copyright © European Psychiatric Association 2008
References
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