RESUMO
INTRODUCTION: Mental rituals (MR) are compulsions with no overt behavioural or motoric signs. It is presently unclear whether MR found in obsessive-compulsive disorder are associated with a distinctive clinical profile. OBJECTIVES: The main objectives of this paper were to assess the prevalence and psychopathological correlates of mental rituals in a large sample of OCD patients. METHODS: This exploratory case-control study compared 519 patients with versus 447 without MR in terms of sociodemographics, presence and severity of obsessive-compulsive symptoms, psychiatric comorbidities, sensory phenomena, suicidality, and insight. RESULTS: Current MR were found in 51.8%, while lifetime MR were found in 55.4% of the sample. The multiple logistic regression model determined that the most relevant clinical factors independently associated with current MR in OCD patients were the absence of any sensory phenomena and the presence of lifetime suicide ideation. CONCLUSION: Due to its relation to OCD clinical aspects, MR are a frequent feature among OCD patients. It also seems to be associated with a range of features that are probably relevant for treatment, especially sensory phenomena and suicidality.
Assuntos
Comportamento Ritualístico , Transtorno Obsessivo-Compulsivo , Humanos , Prevalência , Estudos de Casos e Controles , Transtorno Obsessivo-Compulsivo/psicologia , Comportamento Compulsivo/epidemiologia , Comportamento Compulsivo/psicologiaRESUMO
ABSTRACT Background: Impulsive compulsive behaviors (ICBs) can affect a significant number of Parkinson's disease (PD) patients. Objective: We have studied brain samples from a brain bank of PD patients who received apomorphine via continuous infusion in life to assess the prevalence and outcome of ICBs. Methods: A search on the Queen Square Brain Bank (QSBB) database for cases donated from 2005 to 2016 with a pathological diagnosis of idiopathic PD was conducted. Notes of all donors who used apomorphine via continuous infusion for at least three months were reviewed. Clinical and demographic data were collected, as well as detailed information on treatment, prevalence and outcomes of ICBs. Results: 193 PD cases, 124 males and 69 females, with an average age at disease onset of 60.2 years and average disease duration of 17.2 years were reviewed. Dementia occurred in nearly half of the sample, depression in one quarter, and dyskinesias in a little over 40%. The prevalence of ICBs was 14.5%. Twenty-four individuals used apomorphine infusion for more than three months. Patients on apomorphine had younger age at disease onset, longer disease duration, and higher prevalence of dyskinesias. The prevalence of de novo ICB cases among patients on apomorphine was 8.3%. Apomorphine infusion was used for an average of 63.1 months on an average maximum dose of 79.5 mg per day. Ten patients remained on apomorphine until death. Conclusions: Apomorphine can be used as an alternative treatment for patients with previous ICBs as it has low risk of triggering recurrence of ICBs.
RESUMO Antecedentes: Comportamentos impulsivo-compulsivos (CICs) podem acometer uma parcela significativa de indivíduos com doença de Parkinson (DP). Objetivo: Nós estudamos amostras de tecido cerebral de uma população de pacientes com DP de um banco de cérebros que receberam apomorfina por infusão contínua em vida, com a finalidade de avaliar a prevalência e o desfecho dos CICs. Métodos: Uma pesquisa no banco de dados do Banco de Cérebros de Queen Square foi conduzida à procura de doações recebidas entre 2005 e 2016 com diagnóstico anatomopatológico de DP idiopática. Os prontuários de todos os doadores que usaram apomorfina por infusão contínua por um período mínimo de três meses foram revisados. Dados clínicos e demográficos foram coletados, assim como informações detalhadas sobre o tratamento, prevalência e desfecho dos CICs. Resultados: 193 casos de DP, 124 do sexo masculino e 69 do sexo feminino, com idade média de início da doença de 60,2 anos e tempo médio de duração da doença de 17,2 anos, foram revisados. Aproximadamente metade dos casos apresentaram demência, um quarto depressão, e um pouco mais de 40% discinesias. A prevalência de CICs foi 14,5%. Vinte e quatro indivíduos usaram infusão de apomorfina por mais de três meses. Os pacientes que usaram apomorfina apresentaram DP mais cedo, maior duração da doença, e uma maior prevalência de discinesias. A prevalência de novos casos de CICs entre pacientes usando apomorfina foi de 8,3%. Infusão de apomorfina foi usada em média por 63,1 meses a um dose máxima média de 79,5 mg por dia. Dez pacientes permaneceram usando apomorfina até o óbito. Conclusões: Apomorfina pode ser usada como opção de tratamento alternativo para pacientes que apresentarem CICs no passado considerando seu baixo risco de causar recorrência de CICs.
Assuntos
Humanos , Masculino , Feminino , Doença de Parkinson/tratamento farmacológico , Doença de Parkinson/epidemiologia , Discinesias , Transtornos Disruptivos, de Controle do Impulso e da Conduta , Apomorfina , Prevalência , Estudos Retrospectivos , Comportamento Compulsivo/tratamento farmacológico , Comportamento Compulsivo/epidemiologia , Comportamento ImpulsivoRESUMO
BACKGROUND: Impulsive compulsive behaviors (ICBs) can affect a significant number of Parkinson's disease (PD) patients. OBJECTIVE: We have studied brain samples from a brain bank of PD patients who received apomorphine via continuous infusion in life to assess the prevalence and outcome of ICBs. METHODS: A search on the Queen Square Brain Bank (QSBB) database for cases donated from 2005 to 2016 with a pathological diagnosis of idiopathic PD was conducted. Notes of all donors who used apomorphine via continuous infusion for at least three months were reviewed. Clinical and demographic data were collected, as well as detailed information on treatment, prevalence and outcomes of ICBs. RESULTS: 193 PD cases, 124 males and 69 females, with an average age at disease onset of 60.2 years and average disease duration of 17.2 years were reviewed. Dementia occurred in nearly half of the sample, depression in one quarter, and dyskinesias in a little over 40%. The prevalence of ICBs was 14.5%. Twenty-four individuals used apomorphine infusion for more than three months. Patients on apomorphine had younger age at disease onset, longer disease duration, and higher prevalence of dyskinesias. The prevalence of de novo ICB cases among patients on apomorphine was 8.3%. Apomorphine infusion was used for an average of 63.1 months on an average maximum dose of 79.5 mg per day. Ten patients remained on apomorphine until death. CONCLUSIONS: Apomorphine can be used as an alternative treatment for patients with previous ICBs as it has low risk of triggering recurrence of ICBs.
Assuntos
Transtornos Disruptivos, de Controle do Impulso e da Conduta , Discinesias , Doença de Parkinson , Apomorfina , Comportamento Compulsivo/tratamento farmacológico , Comportamento Compulsivo/epidemiologia , Feminino , Humanos , Comportamento Impulsivo , Masculino , Doença de Parkinson/tratamento farmacológico , Doença de Parkinson/epidemiologia , Prevalência , Estudos RetrospectivosRESUMO
We decided to explore the frequency of cardiovascular risk factors, according to three levels of severity of compulsive sexual behavior (CSB), namely, non-sexually compulsive (1), sexually compulsive (2), and sexually compulsive, and hypersexual (3). We also investigated the impact of a psychiatric co-morbidity on the Framingham heart risk score (FRS). 94 non-sexually compulsive, 57 sexually compulsive, and 60 hypersexual individuals underwent psychiatric interview, blood collection, self-responsiveness, and anthropometric measurement. The analyses were repeated with individuals aged up to 44 and aged more than 44 years old. Regarding the total sample, we observed significant association among those sexually compulsive, and hypersexual participants with presenting the HIV serologic status, and a greater proportion of psychiatric conditions as much as the severity of CSB increases. Individuals with substance-related disorder predicted higher Framingham scores. The analyses with people aged more than 44 years old presented some different results, such as association among presenting low FRS and the sexually compulsive participants, and sexual compulsivity predicted lower scores of the Framingham. The study points out to the relevance of comprehensive psychiatric examination of whom presenting CSB and opens an avenue forward investigation of the effect of high rates of sexual activity on cardiovascular risk.
Assuntos
Doenças Cardiovasculares/epidemiologia , Comportamento Compulsivo/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Brasil/epidemiologia , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND AND AIMS: Gambling disorder (GD) and compulsive sexual behavior (CSB) may commonly co-occur. Yet, the psychiatric correlates of these co-occurring disorders are an untapped area of empirical scrutiny, limiting our understanding of appropriate treatment modalities for this dual-diagnosed population. This study examined the demographic and clinical correlates of CSB in a sample of treatment-seeking individuals with GD (N = 368) in São Paulo, Brazil. METHODS: Psychiatrists and psychologists conducted semi-structured clinical interviews to identify rates of CSB and other comorbid psychiatric disorders. The Shorter PROMIS Questionnaire was administered to assess additional addictive behaviors. The TCI and BIS-11 were used to assess facets of personality. Demographic and gambling variables were also assessed. RESULTS: Of the total sample, 24 (6.5%) met diagnostic criteria for comorbid CSB (GD + CSB). Compared to those without compulsive sexual behaviors (GD - CSB), individuals with GD + CSB were more likely to be younger and male. No differences in gambling involvement emerged. Individuals with GD + CSB tended to have higher rates of psychiatric disorders (depression, post-traumatic stress disorder, and bulimia nervosa) and engage in more addictive behaviors (problematic alcohol use, drug use, and exercise) compared to GD - CSB. Those with GD + CSB evidenced less self-directedness, cooperativeness, self-transcendence, and greater motor impulsivity. Logistic regression showed that the predictors of GD + CSB, which remained in the final model, were being male, a diagnosis of bulimia, greater gambling severity, and less self-transcendence. DISCUSSION AND CONCLUSION: Given those with GD + CSB evidence greater psychopathology, greater attention should be allocated to this often under studied comorbid condition to ensure adequate treatment opportunities.
Assuntos
Comportamento Aditivo/fisiopatologia , Comportamento Compulsivo/fisiopatologia , Jogo de Azar/fisiopatologia , Transtornos Mentais/fisiopatologia , Comportamento Sexual/fisiologia , Adulto , Comportamento Aditivo/epidemiologia , Brasil/epidemiologia , Bulimia/epidemiologia , Bulimia/fisiopatologia , Comorbidade , Comportamento Compulsivo/epidemiologia , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-IdadeRESUMO
Compulsive buying is a common disorder found worldwide. Although recent research has shed light into the prevalence, etiology and clinical correlates of compulsive buying disorder, less is known about gender differences. To address this empirical gap, we assessed potential gender differences in demographic and psychiatric co-morbidities in a sample of 171 compulsive buyers (20 men and 151 women) voluntarily seeking treatment in São Paulo, Brazil. A structured clinical interview confirmed the diagnosis of compulsive buying. Of the 171 participants, 95.9% (n = 164) met criteria for at least one co-morbid psychiatric disorder. The results found that male and female compulsive buyers did not differ in problem severity as assessed by the Compulsive Buying Scale. However, several significant demographic and psychiatric differences were found in a multivariate binary logistic regression. Specifically, male compulsive buyers were more likely to report being non-heterosexual, and reported fewer years of formal education. In regards to psychiatric co-morbidities, male compulsive buyers were more likely to be diagnosed with sexual addiction, and intermittent explosive disorder. Conversely, men had lower scores on the shopping subscale of the Shorter PROMIS Questionnaire. The results suggest that male compulsive buyers are more likely to present with co-morbid psychiatric disorders. Treatment planning for compulsive buying disorder would do well to take gender into account to address for potential psychiatric co-morbidities.
Assuntos
Comportamento Aditivo/psicologia , Comportamento Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Comportamento Aditivo/epidemiologia , Brasil/epidemiologia , Comportamento Compulsivo/epidemiologia , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/epidemiologia , Escalas de Graduação Psiquiátrica , Caracteres Sexuais , Inquéritos e QuestionáriosRESUMO
INTRODUCTION:: Compulsive buying can be characterized as an almost irresistible urge to buy various items. Compulsive buying disorder is a subject of growing interest to health professionals. It is a current issue and the prevalence rate in the global population is around 5 to 8%. OBJECTIVES:: The main objective of this study was to identify predictors of compulsive buying in the Brazilian population, assessing possible relationships between compulsive buying, depression and anxiety. METHODS:: The Richmond Compulsive Buying Scale was administered to screen for compulsive buying and the Hospital Anxiety and Depression Scale was used to assess anxiety and depression in a sample of 359 participants. Pearson coefficients were used to test for correlations. RESULTS:: Our study identified an interaction between female gender and compulsion to purchase. Furthermore, people's occupations also appear to have an influence on the problem. We found a correlation between depressive symptoms and oniomania. CONCLUSION:: Our study has certain limitations, such as the difficulty in recruiting individuals with compulsive buying disorder. Since compulsive buying is a phenomenon that is seldom investigated, it therefore remains unidentified. However, this is nevertheless a pioneering paper on the Brazilian population.
Assuntos
Comportamento Compulsivo/epidemiologia , Comportamento Compulsivo/psicologia , Adulto , Idoso , Ansiedade/epidemiologia , Brasil/epidemiologia , Comportamento Compulsivo/etiologia , Depressão/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Análise de Regressão , Fatores Sexuais , Fatores Socioeconômicos , Adulto JovemRESUMO
Abstract Introduction: Compulsive buying can be characterized as an almost irresistible urge to buy various items. Compulsive buying disorder is a subject of growing interest to health professionals. It is a current issue and the prevalence rate in the global population is around 5 to 8%. Objectives: The main objective of this study was to identify predictors of compulsive buying in the Brazilian population, assessing possible relationships between compulsive buying, depression and anxiety. Methods: The Richmond Compulsive Buying Scale was administered to screen for compulsive buying and the Hospital Anxiety and Depression Scale was used to assess anxiety and depression in a sample of 359 participants. Pearson coefficients were used to test for correlations. Results: Our study identified an interaction between female gender and compulsion to purchase. Furthermore, people's occupations also appear to have an influence on the problem. We found a correlation between depressive symptoms and oniomania. Conclusion: Our study has certain limitations, such as the difficulty in recruiting individuals with compulsive buying disorder. Since compulsive buying is a phenomenon that is seldom investigated, it therefore remains unidentified. However, this is nevertheless a pioneering paper on the Brazilian population.
Resumo Introdução: A compra compulsiva pode ser caracterizada como um desejo quase irresistível de obter vários itens. O transtorno do comprar compulsivo tem sido objeto de interesse crescente para os profissionais de saúde. Considerado um problema atual, sua taxa de prevalência é de cerca de 5 a 8% na população mundial. Objetivos: O principal objetivo desta pesquisa foi identificar os preditores da compulsão por comprar na população brasileira, avaliando possíveis relações entre compra compulsiva, depressão e ansiedade. Métodos: A Escala de Compras Compulsivas Richmond Adaptada foi utilizada para rastreio do comprar compulsivo, e a Escala Hospitalar de Ansiedade e Depressão, para avaliar ansiedade e depressão, em uma amostra de 359 participantes. As correlações foram determinadas usando o teste de Pearson. Resultados: Foi identificada em nosso estudo uma interação entre sexo feminino e compulsão por compras. Além disso, a ocupação parece interferir no problema. Encontramos uma correlação entre sintomas depressivos e oniomania. Conclusão: Nosso estudo apresenta algumas limitações, tais como a dificuldade em recrutar indivíduos com transtorno do comprar compulsivo. Por ser um tema pouco explorado, há uma dificuldade em identificar indivíduos acometidos. No entanto, este é um ensaio pioneiro na população brasileira.
Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Adulto Jovem , Comportamento Compulsivo/psicologia , Comportamento Compulsivo/epidemiologia , Ansiedade/epidemiologia , Escalas de Graduação Psiquiátrica , Fatores Socioeconômicos , Brasil/epidemiologia , Fatores Sexuais , Prevalência , Análise de Regressão , Comportamento Compulsivo/etiologia , Depressão/etiologia , Pessoa de Meia-IdadeRESUMO
AIMS: To estimate the pooled prevalence of compulsive buying behaviour (CBB) in different populations and to determine the effect of age, gender, location and screening instrument on the reported heterogeneity in estimates of CBB and whether publication bias could be identified. METHODS: Three databases were searched (Medline, PsychInfo, Web of Science) using the terms 'compulsive buying', 'pathological buying' and 'compulsive shopping' to estimate the pooled prevalence of CBB in different populations. Forty studies reporting 49 prevalence estimates from 16 countries were located (n = 32,000). To conduct the meta-analysis, data from non-clinical studies regarding mean age and gender proportion, geographical study location and screening instrument used to assess CBB were extracted by multiple independent observers and evaluated using a random-effects model. Four a priori subgroups were analysed using pooled estimation (Cohen's Q) and covariate testing (moderator and meta-regression analysis). RESULTS: The CBB pooled prevalence of adult representative studies was 4.9% (3.4-6.9%, eight estimates, 10,102 participants), although estimates were higher among university students: 8.3% (5.9-11.5%, 19 estimates, 14,947 participants) in adult non-representative samples: 12.3% (7.6-19.1%, 11 estimates, 3929 participants) and in shopping-specific samples: 16.2% (8.8-27.8%, 11 estimates, 4686 participants). Being young and female were associated with increased tendency, but not location (United States versus non-United States). Meta-regression revealed large heterogeneity within subgroups, due mainly to diverse measures and time-frames (current versus life-time) used to assess CBB. CONCLUSIONS: A pooled estimate of compulsive buying behaviour in the populations studied is approximately 5%, but there is large variation between samples accounted for largely by use of different time-frames and measures.
Assuntos
Comportamento Compulsivo/epidemiologia , Distribuição por Idade , Austrália/epidemiologia , Brasil/epidemiologia , Comércio , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Análise de Regressão , República da Coreia/epidemiologia , Distribuição por Sexo , Estudantes , Taiwan/epidemiologia , Estados Unidos/epidemiologia , UniversidadesRESUMO
INTRODUCTION: Compulsive buying can be characterized as an almost irresistible impulse to acquire various items. This is a current issue and the prevalence rate in the global population is around 5 to 8%. Some surveys indicate that the problem is growing in young and low-income populations. OBJECTIVES: To evaluate the prevalence of compulsive buying among people with low personal monthly incomes and analyze relationships with socio-demographic data. METHODS: The Compulsive Buying Scale was administered to screen for compulsive buying and the Hospital Anxiety and Depression Scale was used to assess anxiety and depression in a sample of 56 participants. Pearson coefficients were used to test for correlations. RESULTS: The results indicated that 44.6% presented an average family income equal to or greater than 2.76 minimum wages. It is possible that compulsive buying is not linked to the purchasing power since it was found in a low-income population. CONCLUSION: Despite the small sample, the results of this study are important for understanding the problem in question.
Assuntos
Comportamento Compulsivo/epidemiologia , Pobreza , Adulto , Ansiedade/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Adulto JovemRESUMO
Introduction: Compulsive buying can be characterized as an almost irresistible impulse to acquire various items. This is a current issue and the prevalence rate in the global population is around 5 to 8%. Some surveys indicate that the problem is growing in young and low-income populations. Objectives: To evaluate the prevalence of compulsive buying among people with low personal monthly incomes and analyze relationships with socio-demographic data. Methods: The Compulsive Buying Scale was administered to screen for compulsive buying and the Hospital Anxiety and Depression Scale was used to assess anxiety and depression in a sample of 56 participants. Pearson coefficients were used to test for correlations. Results: The results indicated that 44.6% presented an average family income equal to or greater than 2.76 minimum wages. It is possible that compulsive buying is not linked to the purchasing power since it was found in a low-income population. Conclusion: Despite the small sample, the results of this study are important for understanding the problem in question.
Introdução: A compra compulsiva pode ser caracterizada como um impulso quase irresistível de obter diversos itens. Considerada um problema da atualidade, estima-se que sua taxa de prevalência seja em torno entre 5 a 8% na população mundial. Algumas pesquisas sinalizam um aumento do problema entre jovens e populações de baixa renda. Objetivos: Avaliar a prevalência da compra compulsiva em sujeitos com baixa renda mensal individual e analisar as relações entre os dados sociodemográficos. Método: A Compulsive Buying Scale (CBS) foi utilizada para rastrear compra compulsiva, e a Hospital Anxiety and Depression Scale (HADS), para avaliar ansiedade e depressão em uma amostra de 56 participantes. Correlações foram verificadas através do teste de Pearson. Resultados: Os resultados indicaram que 44,6% apresentavam renda média familiar igual ou maior a 2,76 salários mínimos. É possível que a compra compulsiva não esteja vinculada ao poder aquisitivo, uma vez que ela foi encontrada em uma população com baixa renda. Conclusão: Embora a amostra seja pequena, os resultados obtidos são importantes para compreender o problema em questão.
Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Pobreza , Comportamento Compulsivo/epidemiologia , Ansiedade/epidemiologia , Escalas de Graduação Psiquiátrica , Brasil/epidemiologia , Prevalência , Estudos Transversais , Depressão/epidemiologia , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: There is evidence of an association between the practice of intentional unsafe sex among men who have sex with men (MSM) and sensation seeking and impulsivity. However, other aspects of personality have been less frequently investigated. AIMS: This study aims to investigate the association between the practice of intentional unsafe sex and personality traits in individuals who sought treatment and met the criteria for compulsive sexual behavior in São Paulo, Brazil. METHODS: The sample consisted of 69 sexually compulsive MSM. The participants underwent psychiatric evaluation and an interview to define intentional condomless sex and completed self-report instruments. MAIN OUTCOME MEASURES: The participants completed the following measures: the Temperament and Character Inventory and the Sexual Compulsivity Scale. RESULTS: Twenty-five participants (36%) reported intentional unsafe sex with casual partners, of whom 84% were gay and 16% bisexual (P<0.05). Fifteen (22%) individuals reported being HIV positive, and 11 (73%) of them practiced intentional unprotected anal intercourse (P<0.05). The mean of sexual compulsivity was associated with men who engaged in intentional unsafe sex (P=0.01). Men who reported intentional unsafe sex scored significantly higher on the novelty seeking temperament dimension (P<0.05) and scored significantly lower on the self-directedness character dimension (P<0.001). However, self-directedness predicted intentional unsafe sex in the multiple logistic regression (P=0.001). CONCLUSIONS: Sexually compulsive individuals who practiced intentional unsafe sex presented lower self-directedness than the group who did not engage in intentional unsafe sex, which suggests less autonomy regarding life itself. To the best of our knowledge, this is the first study to consider intentional unsafe sex in sexually compulsive men.
Assuntos
Bissexualidade/psicologia , Comportamento Compulsivo/psicologia , Homossexualidade Masculina/psicologia , Transtornos da Personalidade/diagnóstico , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Sexo sem Proteção/psicologia , Adulto , Atitude Frente a Saúde , Brasil/epidemiologia , Comportamento Compulsivo/epidemiologia , Soropositividade para HIV , Humanos , Modelos Logísticos , Masculino , Determinação da Personalidade , Transtornos da Personalidade/epidemiologia , Autorrelato , Comportamento Sexual/estatística & dados numéricos , Sexo sem Proteção/estatística & dados numéricosRESUMO
This study examined compulsive sexual behavior (CSB) and psychopathology in a treatment-seeking sample of men in São Paulo, Brazil. Eighty-six men (26% gay, 17% bisexual, 57% heterosexual) who met diagnostic criteria for excessive sexual drive and sexual addiction completed assessments consisting of the Mini International Neuropsychiatric Interview, a structured clinical interview for DSM-IV Axis I Disorders-Clinical Version (segment for Impulse Control Disorder), Sexual Compulsivity Scale (SCS), and questions about problematic CSB. The average SCS score for our sample was above the cut-off score reported in other studies, and 72% of the sample presented at least one Axis I psychiatric diagnosis. There were no differences among gay, bisexual, and heterosexual men on SCS scores and psychiatric conditions, but gay and bisexual men were more likely than heterosexual men to report casual sex and sex with multiple casual partners as problematic behaviors. SCS scores were associated with psychiatric co-morbidities, mood disorder, and suicide risk, but diagnosis of a mood disorder predicted higher SCS scores in a regression analysis. The study provides important data on the mental health needs of men with CSB in São Paulo, Brazil.
Assuntos
Transtorno da Personalidade Antissocial/epidemiologia , Transtorno da Personalidade Antissocial/psicologia , Comportamento Compulsivo/epidemiologia , Comportamento Compulsivo/psicologia , Comportamento Sexual , Brasil/epidemiologia , Comportamento Compulsivo/fisiopatologia , Feminino , Humanos , Modelos Lineares , Masculino , Escalas de Graduação Psiquiátrica , Psicopatologia , AutorrelatoRESUMO
INTRODUÇÃO: A Escala de Compras Compulsivas (CBS) é um instrumento breve e de fácil aplicação, que visa avaliar as principais dimensões do transtorno das compras compulsivas, centrando-se no controle dos impulsos. OBJETIVO: O presente estudo tem como objetivo validar e aferir a fidedignidade da versão brasileira da Escala de Compras Compulsivas (CBS). MÉTODOS: Para validade de construto, foi realizada análise fatorial com extração dos componentes principais e rotação Varimax. A correlação entre a escala CBS e as medidas de depressão e ansiedade, assim como do transtorno obsessivo-compulsivo, foi avaliada por meio do coeficiente de Pearson, para estudo da validade convergente e divergente. A consistência interna foi aferida por meio do coeficiente alfa de Cronbach. RESULTADO: A CBS apresentou bons parâmetros psicométricos, sendo considerada válida e fidedigna em sua versão brasileira. No que concerne às correlações, a CBS apresenta uma correlação inversamente proporcional com outras escalas diagnósticas para o transtorno das compras compulsivas, indicando, portanto, ser um excelente instrumento de aferição dessa desordem. A CBS apresentou alto coeficiente alfa de Cronbach (0,86), demonstrando boa confiabilidade. CONCLUSÃO: Embora seja uma escala curta, com poucos itens, a versão brasileira da escala de compras compulsivas apresenta boas propriedades psicométricas, apresentando-se como um importante instrumento para avaliação desse construto.
BACKGROUND: The Compulsive Buying Scale is a short and easy-to-apply instrument, which comprises the main dimensions of the compulsive buying disorder, focusing on impulse control. OBJECTIVE: This study aims to validate and assess the reliability of the Brazilian version of the Compulsive Buying Scale. METHODS: To assess construct validity, a factor analysis with principal components extraction and Varimax rotation was conducted. The correlations between the CBS and measures for depression, anxiety, and obsessive-compulsive disorder were assessed with the Pearson coefficient, evaluating convergent and divergent validity. The internal consistency was measured using Cronbach's alpha coefficient. RESULT: The psychometric parameters of the Brazilian version of the CBS were satisfactory and the instrument was considered valid and reliable. The CBS showed an inversely correlation with other diagnostic scales for the compulsive buying disorder. Cronbach's alpha coefficient (0.86) was high, demonstrating a satisfactory reliability of the Portuguese CBS. DISCUSSION: Although the Brazilian version of the Compulsive Buying Scale is a short version with just a few items, the scale has excellent psychometric properties, presenting itself as an important tool to detect and evaluate compulsive buying disorder.
Assuntos
Humanos , Masculino , Feminino , Adulto , Análise Fatorial , Comportamento Compulsivo/diagnóstico , Comportamento Compulsivo/epidemiologia , Escalas de Graduação Psiquiátrica , Estudo de Validação , Psicometria , Reprodutibilidade dos Testes , Transtorno Obsessivo-Compulsivo/diagnósticoRESUMO
OBJECTIVE: The principal aims of this study were to examine the prevalence rate, clinical characteristics, and related factors of postpartum obsessive-compulsive disorder (OCD). METHOD: The subjects were a nonclinical sample of 400 postpartum women. They were interviewed from the 2nd up to the 26th week after birth. The Mini International Neuropsychiatric Interview was used for diagnosis of OCD, the Yale-Brown Obsessive-Compulsive Symptom Checklist was used to determine the types of obsessions and compulsions, and the Structured Clinical Interview for DSM-IV Axis I Disorders was used to diagnose comorbid depressive episode. RESULTS: Thirty-six (9%) of the sample met the diagnostic criteria for OCD according to the Mini International Neuropsychiatric Interview, and 9 (2.3%) reported postpartum onset OCD. Obsessive-compulsive disorder was more frequent in mothers with personal history of previous psychiatric disorder, somatic disease, or obstetric complication in pregnancy/birth, and who were multiparous. The most common obsessions were aggressive, contamination and miscellaneous, and compulsion for washing/cleaning and checking, and 38.9% have a comorbid depressive episode. CONCLUSION: Women have increased risk of OCD or obsessive-compulsive symptoms in the postpartum period. For this reason, all women, particularly women with previous psychiatric history, somatic disease, or with complications in pregnancy or at the birth should be carefully screened for OCD in the postpartum period.
Assuntos
Transtorno Obsessivo-Compulsivo/epidemiologia , Período Pós-Parto/psicologia , Adulto , Brasil/epidemiologia , Comportamento Compulsivo/epidemiologia , Feminino , Humanos , Paridade , Gravidez , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Fatores SocioeconômicosRESUMO
OBJECTIVE: The main characteristic of body dysmorphic disorder (BDD) is a preoccupation with an imagined defect in appearance in a normal-appearing person or an excessive preoccupation with appearance in a person with a small physical defect. In this non-controlled study, our objective was to describe the socio-demographic, phenomenological, and long-term outcome features of a Brazilian sample of patients with BDD. METHODS: We performed a chart-review of the 166 patients who attended the Obsessions, Compulsions, and Impulsions Subprogram of the Institute of Psychiatry of the Federal University of Rio de Janeiro, Brazil, during the period between 1998 and 2005. RESULTS: Twenty patients (12%) had clinically significant BDD. This sample was characterized by a predominance of female (n = 11; 55%), single or divorced (n = 18; 90%), and economically unproductive patients (n = 17; 85%). We found an average of 2.5 current imagined defects per patient. The most frequently reported body parts of excessive concern were the overall appearance, size or shape of the face (n = 7; 35%), the skin (n = 6; 30%), the hair (n = 6; 30%), the nose (n = 5; 25%), and the body build and weight (n = 5; 25%). Most individuals exhibited a chronic condition (n = 13; 65%) and kept the same concerns during the course of the disorder (n = 12; 60%). All patients displayed compulsive behaviors, including recurrent mirror checking (n = 14; 70%), camouflaging (n = 13; 65%), reassurance seeking by means of repetitive questioning of others (n = 9; 45%), and excessive use of cosmetics (n = 7; 35%). Two patients reported "do-it-yourself" surgeries. Seven patients had current suicidal ideation (35%). Six patients (30%) showed no insight over their dysmorphic beliefs. Fifteen patients (95%) exhibited psychiatric comorbidities, mostly obsessive-compulsive disorder (OCD) (n = 14, 70%) and major depressive disorder (n = 11; 55%). The majority of patients were treated naturalistically with serotonin reuptake inhibitors (n = 15; 75%), either solo or in association with antipsychotics (n = 10; 50%). Nevertheless, only 5 (25%) responded favorably to treatment during the long-term follow-up (CGI < or = 2). CONCLUSIONS: BDD is a severe disorder that is frequently associated with other psychiatric conditions and responds poorly to treatment in the naturalistic setting. No significant trans-cultural variations were identified in the comparison between Brazilian, North American, and European samples.
Assuntos
Fatores Socioeconômicos , Transtornos Somatoformes/epidemiologia , Brasil , Doença Crônica , Comorbidade , Comportamento Compulsivo/diagnóstico , Comportamento Compulsivo/epidemiologia , Comportamento Compulsivo/psicologia , Comparação Transcultural , Estudos Transversais , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Seguimentos , Humanos , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Estudos Retrospectivos , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/psicologiaRESUMO
We investigated whether patients with obsessive-compulsive disorder (OCD) and hoarding symptoms can be differentiated from their counterparts with other types of obsessions and compulsions in terms of sociodemographic and clinical features. Ninety-seven patients with OCD were assessed with a sociodemographic and clinical questionnaire, the Structured Clinical Interview for DSM-IV (SCID-I), the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Depression (HDRS), and the Global Assessment of Functioning (GAF). Fifteen patients who reported hoarding symptoms in the Y-BOCS checklist (15.6% of the total sample) were compared and contrasted with 82 patients without those symptoms using the Mann-Whitney U test for continuous variables and the Pearson's goodness-of-fit chi-square test for categorical ones; Fisher's exact test was employed when indicated. Hoarders were characterized by (1) higher educational levels (chi(2) = 7.49; df = 2; P =.02); (2) earlier age at onset (Z = -2.99; P =.003); (3) higher rates of symmetry obsessions (chi(2) = 7.03; df = 1; P =.01); (4) greater frequency of ordering (chi(2) = 10.08; df = 1; P =.004); (5) rituals repetition (chi(2) = 4.42; df = 1; P =.03); (6) counting compulsions (chi(2) = 5.92; df = 1; P =.02); and (7) significantly higher rates of comorbidity with bipolar II disorder (chi(2) = 10.62; df = 1; P =.02) and (8) with eating disorders (chi(2) = 7.42; df = 1; P =.02). In conclusion, patients with OCD exhibiting hoarding feature a distinctive sociodemographic and clinical profile. It remains to be investigated whether these phenotypical characteristics are underlined by specific neurobiological mechanisms.
Assuntos
Comportamento Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Adolescente , Adulto , Idoso , Comorbidade , Comportamento Compulsivo/diagnóstico , Demografia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtornos da Personalidade/epidemiologia , Índice de Gravidade de Doença , Inquéritos e QuestionáriosRESUMO
Los desórdes alimentarios anorexia y bulimia nerviosas afectan en la actualidad a gran número de jóvenes y pueden causar severo impacto en la salud bucal. La erosión dentaria es una secuela frecuente en pacientes con vómitos autoinducidos. El objetivo de este trabajo fue establecer la relación existente entre el diagnóstico psicopatológico de la enfermedad y la patología dentaria. Fueron incluidas en el estudio 59 adolescentes de 17,4 +- 2,8 años que concurrieron al Servicio de Adolescencia del Hospital Dr. Cosme Argerich y 59 pacientes de igual sexo y edad pertenecientes al área programática del mismo hospital. Se realizó el examen clínico bucal con registro de CPOD, mancha blanca y erosión dental. El diagnóstico psicopatológico se realizó según criterios DSM I V. Los resultados revelaron: 32.2 por ciento de pacientes con diagnóstico de anorexia nerviosa subtipo restrictivo (ANR); 15.2 por ciento anorexia nerviosa subtipo purgativo (ANP); 35.6 por ciento bulimia nerviosa subtipo purgativo (BNP); 1.7 por ciento compulsión alimentaria (BED); 6.7 por ciento trastornos no específicos (TANE); 8.5 por ciento otras patologías. El 50.8 por ciento manifestaron episodios de vómitos autoinducidos. El índice CPOD mostró los siguientes promedios: 4.7 +- 0.80 en pacientes con ANR; 5.7 por ciento +- 1.21,5 en ANP; 6.4 +- 1 en BNP; 2.5 +- 1.6 en TANE y 2.6 +-2.1 en pacientes con otras patologías. Se registró erosión grado 1 en el 25,4 por ciento de los casos y mancha blanca en el 25 por ciento. El índice CPOD del grupo control fue 6.91+-0.55 y el de purgativas 6.23+-0.80 sin diferencias significativas. Conclusiones: las pacientes con conductas restrictivas presentaron menor índice CPOD que las pacientes con conductas compensatorias como el vómito. La prevalencia del grupo de pacientes vomitadoras no presentó diferencias significativas comparado con el grupo control de reisgo social homogéneo. En estadio tempranos de la enfermedad la erosión es limitada al esmalte de las caras palatinas de los dientes anterosuperiores (AU)