ABSTRACT
OBJECTIVE: The present study was designed to evaluate the psychometric properties of the Brazilian Portuguese version of the Obsessive-Compulsive Inventory - Revised. METHOD: The Obsessive-Compulsive Inventory - Revised was administered to a total of 260 participants: a clinical sample of 130 patients with anxiety disorders (64 with a diagnosis of obsessive-compulsive disorder patients, 33 diagnosed with social phobia, and 33 with panic disorder) and a sample of 130 non-clinical subjects. RESULTS: The findings indicate that the Obsessive-Compulsive Inventory - Revised is a valid measure for identifying and assessing the severity of the six symptom subtypes in obsessive-compulsive disorder. The original factor structure of the instrument was replicated in an exploratory factor analysis. Test-retest reliability was examined using data from 64 obsessive-compulsive disorder patients who completed the inventory on two different occasions. In each sample, the overall and subscale scores showed moderate to good internal consistency, good convergent and divergent validity, and sensitivity to changes resulting from cognitive-behavioral group therapy. CONCLUSION: Our findings indicate that the Brazilian Portuguese version of the Obsessive-Compulsive Inventory - Revised retains the psychometric properties of its original version and the Spanish, German and Icelandic versions.
OBJETIVO: O presente estudo foi delineado para avaliar as propriedades psicométricas da versão em português do Brasil do Obsessive-Compulsive Inventory - Revised. MÉTODO: O Obsessive-Compulsive Inventory - Revised foi aplicado em um total de 260 indivíduos: em uma amostra clínica de 130 pacientes (64 pacientes com transtorno obsessivo-compulsivo, 33 pacientes com fobia social e 33 pacientes com transtorno do pânico) mais uma amostra não clínica de 130 sujeitos. RESULTADOS: Os resultados indicam que o Obsessive-Compulsive Inventory - Revised é uma medida válida para identificar e avaliar a severidade dos seis subtipos de sintomas do transtorno obsessivo-compulsivo. A estrutura fatorial do instrumento foi replicada em uma análise fatorial exploratória. A confiabilidade teste-reteste foi examinada usando os dados de 64 pacientes com transtorno obsessivo-compulsivo que completaram o inventário em dois momentos diferentes. Em cada amostra, os escores total e das subescalas mostraram consistência interna de boa a moderada, boa validade concorrente e discriminante, e sensibilidade para as mudanças da terapia cognitivo-comportamental em grupo. CONCLUSÃO: Nossos achados indicam que a versão para o português do Brasil do Obsessive-Compulsive Inventory - Revised manteve as propriedades psicométricas da versão original e das versões em espanhol, alemão e islandês.
Subject(s)
Adult , Female , Humans , Male , Obsessive-Compulsive Disorder/diagnosis , Surveys and Questionnaires , Brazil , Case-Control Studies , Cultural Characteristics , Language , Psychological Tests , Psychometrics , Sensitivity and Specificity , Severity of Illness Index , TranslatingABSTRACT
OBJECTIVE: Recent factor-analytic studies of obsessive-compulsive disorder identified consistent symptom dimensions. This study was designed in order to observe which obsessive compulsive symptom dimensions could be changed by adding two individual sessions of motivational interviewing and thought mapping of cognitive-behavioral group therapy using a randomized clinical trial. METHOD: Forty outpatients with a primary diagnosis of obsessive-compulsive disorder were randomly assigned to receive cognitive-behavioral group therapy (control group) or motivational interviewing+thought mapping plus cognitive-behavioral group therapy. To evaluate changes in symptomdimensions, the Dimensional Yale-Brown Obsessive-Compulsive Scale was administered at baseline and after treatment. RESULTS: At post-treatment, there were statistically significant differences between cognitive-behavioral group therapy and motivational interviewing+thought mapping+cognitivebehavioral group therapy groups in the mean total Dimensional Yale-Brown Obsessive-Compulsive Scale score, and in the contamination and aggression dimension score. Hoarding showed a statistical trend towards improvement. CONCLUSION: These findings suggest that adding motivational interviewing+thought mapping to cognitive-behavioral group therapy can facilitate changes and bring about a decrease in the scores in different obsessive-compulsive disorder symptom dimensions, as measured by the Dimensional Yale-Brown Obsessive-Compulsive Scale. Nonetheless, additional trials are needed to confirm these results.
OBJETIVO: Recentes estudos utilizando análise fatorial no transtorno obsessivocompulsivo identificaram dimensões consistentes dos sintomas. Este estudo foi delineado para observar quais dimensões dos sintomas obsessivo-compulsivos podem ser modificadas adicionando duas sessões individuais de entrevista motivacional e mapeamento cognitivo à terapia cognitivo-comportamental em grupo usando um ensaio clínico randomizado. MÉTODO: Quarenta pacientes ambulatoriais com diagnóstico primário de transtorno obsessivo-compulsivo foram alocados aleatoriamente para receber terapia cognitivo-comportamental em grupo (grupo controle) ou entrevista motivacional+mapeamento cognitivo+terapia cognitivo-comportamental em grupo. Para avaliar mudanças nas dimensões dos sintomas, foi administrada a Escala Dimensional para Sintomas Obsessivo-Compulsivos de Yale-Brown antes do início e após o tratamento. RESULTADOS: Ao final do tratamento houve diferença estatisticamente significativa entre a terapia cognitivo-comportamental em grupo e entrevista motivacional+mapeamento cognitivo+terapia cognitivocomportamental em grupo na média do escore total da Escala Dimensional para Sintomas Obsessivo-Compulsivos de Yale-Brown e no escore da dimensão de contaminação e agressão. Colecionismo apresentou melhora com tendência estatística. CONCLUSÃO: Esses achados sugerem que acrescentar entrevista motivacional+mapeamento cognitivo à terapia cognitivo-comportamental em grupo pode facilitar mudanças na redução dos escores nas diferentes dimensões dos sintomas, como indicado pela Escala Dimensional para Sintomas Obsessivo-Compulsivos de Yale-Brown. No entanto, são necessários estudos adicionais para confirmar estes resultados.
Subject(s)
Adolescent , Aged , Female , Humans , Middle Aged , Young Adult , Cognitive Behavioral Therapy/methods , Motivation , Obsessive-Compulsive Disorder/therapy , Psychotherapy, Group/methods , Thinking , Obsessive-Compulsive Disorder/diagnosis , Outpatients , Statistics, Nonparametric , Treatment Outcome , Young AdultABSTRACT
Objective: To develop a cognitive-behavioral group therapy protocol and to verify its efficacy to reduce obsessive-compulsive symptoms. Methods: An open clinical trial with 32 obsessive-compulsive patients was performed, in which a cognitive-behavioral group therapy protocol of 12 weekly sessions of two hours, in 5 consecutive groups, was applied. The severity of symptoms was rated with the Yale-Brown Obsessive-Compulsive (Y-BOCS), Hamilton Anxiety (HAM A) and Hamilton Depression (HAM D) scales. The patients were followed up for 3 months after the end of the treatment. Results: There was a significant reduction in the scores of Y-BOCS, HAM A and HAM D scales with the treatment regardless the use of anti-obsessive medications. The rate of improved patients (decrease of > or = 35 percent in Y-BOCS) was 78.1 percent. Two patients (6.25 percent) dropped out from the study. The effect size calculated for the Y-BOCS scale was 1.75. Conclusions: This study suggests that cognitive-behavioral group therapy reduces obsessive-compulsive symptoms. In addition, patients presented good compliance
ABSTRACT
Selective serotonin reuptake inhibitors (SSRIs), clomipramine, and behavior therapy are the first line treatments for obsessive-compulsive (OCD) symptoms. One of the main reasons for treatment non-compliance and early discontinuation of medications by patients or premature change in prescriptions by clinicians are their side effects. Nausea, headache, insomnia, restlessness, sexual dysfunction, and tremors are common with SSRIs; hypotension, dry mouth, constipation, urinary retention, blurred vision, weight gain, sedation and cardiocirculatory problems, with clomipramine. The strategies and guidelines for these drugs' side effects management are here reviewed, based mainly in case reports and clinical experience. The clinician should be aware of the importance of addressing this issue, educating patients about the most frequent adverse reactions, and how to deal with them in order to prevent unwanted medication discontinuation, and enhance compliance with the treatment