Comorbidade no transtorno obsessivo-compulsivo

<abstract language="eng">Epidemiological and clinical studies indicate that obsessive-compulsive disorder frequently occurs with comorbid disorders. Comorbidity with anxiety and mood disorders, substance abuse or dependence, somatoform, impulse control and tic disorders deserve special attention. In this paper a review of the concept, epidemiological findings, social and occupational functioning, and sequence of comorbid disorders in OCD is presented

Prevalence of obsessive-compulsive disorder in Turkish university students and assessment of associated factors

<p>Abstract</p> <p>Background</p> <p>Many students who begin university at risky periods for OCD development cannot meet the new challenges successfully. They often seek help and apply to the university health center for psychiatric distress. We aimed to determine the prevalence and associated factors of Obsessive Compulsive Disorder (OCD) at students of the Cukurova University in this cross sectional study.</p> <p>Methods</p> <p>This study was performed in the Cukurova University Faculty of Education with a population of 5500 students; the representative sample size for detecting the OCD prevalence was calculated to be 800. After collecting sociodemographic data, we questioned the students for associated factors of OCD. The General Health Questionnaire-12 (GHQ-12) and Composite International Diagnostic Interview (CIDI, Section K) were used for psychiatric evaluation. Logistic regression analysis was performed to evaluate the linkage between OCD and associated factors.</p> <p>Results</p> <p>A total of 804 university students were included in this study. The GHQ-12-positive students (241 students, 29.9%) were interviewed using Section K of the CIDI (222 students, 27.6%). OCD was diagnosed in 33 (4.2%) students. The Logistic regression analysis of the data showed significant associations between OCD and male gender (p:0.036), living on government dormitory (p: 0.003), living on students' house/parental house (p:0.006), having private room in the parental house (p:0.055) and verbal abuse in the family (p:0.006).</p> <p>Conclusion</p> <p>This study demonstrates a higher prevalence of OCD among a group of university students compared to other prevalence studies of OCD in Turkish society. Furthermore, our findings also suggest relationships between OCD and sociodemographic factors, as well as other environmental stress factors.</p

Clinical subtypes of obsessive-compulsive disorder based on the presence of checking and washing compulsions Subtipos clínicos do transtorno obsessivo-compulsivo com base na presença de compulsões de checagem e lavagem

OBJECTIVE: We aimed at examining the utility of checking and washing compulsions as markers of valid subtypes of obsessive-compulsive disorder (OCD). METHODS: One hundred and six patients with obsessive-compulsive disorder were evaluated with a socio-demographic and clinical questionnaire, the Structured Clinical Interview for DSM-IV, the Yale-Brown Obsessive-Compulsive Scale, the Clinical Global Impression, the Beck Depression Inventory, the Hamilton Rating Scale for Depression, and the Global Assessment of Functioning. These individuals were allocated in one of four subgroups [checkers (OCD-Ch; n = 20), washers (OCD-Wa; n = 13), checkers and washers (OCD-CW; n = 48), and non-checkers and non-washers (OCD non-CW = 25)] on the basis of the presence and the clinical relevance of checking and/or washing compulsive behaviors across their lifetime. Socio-demographic and clinical variables were compared and contrasted between the groups by means of ANOVA followed by post-hoc Least Significant Difference or Dunnett's tests for continuous variables and chi-square tests followed by partitioned chi-square tests for categorical variables. RESULTS: OCD-Ch and OCD-Wa did not differ on most demographic and clinical features, the only exception being the number of different types of obsessions, which were significantly higher in the former group. The OCD-CW group was more likely to exhibit an insidious onset of obsessive-compulsive symptoms, to manifest itself as a mixed subtype of obsessive-compulsive disorder and to display obsessions with contamination themes. On the other hand, the OCD non-CW group was more likely to exhibit an acute onset, a shorter duration of illness, obsessions with religious themes, an episodic course, and less severe obsessive-compulsive symptoms. CONCLUSIONS: In our sample, the probing of the presence of checking and/or washing compulsions has provided significant empirical support to establish valid subtypes of obsessive-compulsive disorder.<br>OBJETIVO: Nós investigamos a utilidade das compulsões de verificação e de lavagem como marcadores de subtipos válidos do transtorno obsessivo-compulsivo (TOC). MÉTODOS: Cento e seis pacientes com transtorno obsessivo-compulsivo foram avaliados com um questionário sociodemográfico e clínico e com a entrevista clínica estruturada para o DSM-IV, a escala de sintomas obsessivo-compulsivos de Yale-Brown, a escala de impressão clínica global, o inventário de depressão de Beck, a escala para avaliação de depressão de Hamilton e a avaliação global de funcionamento. Estes indivíduos foram incluídos em um dos seguintes subgrupos: verificadores (TOC-Ver; n = 20), lavadores (TOC-Lav; n = 13), verificadores e lavadores (TOC-VL; n = 48) e não-verificadores e não-lavadores (TOC-NVL = 25). Esta classificação foi realizada com base na presença e relevância clínica de compulsões de verificação e de lavagem ao longo da vida dos pacientes. As variáveis sociodemográficas e clínicas foram comparadas e contrastadas entre os subgrupos através de uma ANOVA seguida pelos testes LSD ou Dunnett para variáveis contínuas e do teste do qui-quadrado seguido pelo qui-quadrado particionado para variáveis categóricas. RESULTADOS: Os pacientes com TOC-Ver e os pacientes com TOC-Lav não diferiram significativamente entre si na maioria das variáveis incluídas no estudo, com exceção do número de diferentes tipos de obsessões, significativamente maior nos primeiros. Os pacientes com TOC-VL exibiram, com maior freqüência, um início insidioso, o subtipo misto de TOC segundo a CID-10 e obsessões de contaminação. Pacientes com TOC-NVL apresentaram, com maior freqüência, um início súbito, menor duração de sintomas, obsessões de conteúdo religioso, curso episódico e sintomas obsessivo-compulsivos menos graves. CONCLUSÕES: A investigação quanto à presença de compulsões de verificação e lavagem sugeriu que estes sintomas podem contribuir para validar subtipos de transtorno obsessivo-compulsivo