Psychopathy Checklist: Youth Version psychometric properties in an Item Response Theory polytomous model / Propriedades psicométricas da Psychopathy Checklist: Youth Version em um modelo politômico da Teoria da Resposta ao Item

This study assessed the applicability of the Psychopathy Checklist: Youth Version in a sample of teenagers confined in socio-educational institutions. Using an Item Response Theory approach, item properties of this instrument were reviewed using the generalized partial credit model. Eight of the original twenty items of the original instrument were discarded due to low discrimination parameters. As expected, the most discriminating items in the assessment of psychiatric traits were those which affective characteristics are more typical in the description of psychopathic traits, and their larger variability among juveniles is reflected in the checklist's answers. Item anchoring, in turn, determined five anchor levels. Conclusions based on the results are twofold: (a) a shorter version of this measure can offer the same level of information obtained from the full instrument and (b) the measure provides more information on average latent trait levels and is inadequate for clinical use.

Este estudo investigou a aplicabilidade da Psychopathy Checklist: Youth Version em uma amostra de adolescentes em cumprimento de medidas socioeducativas. Com base na Teoria de Resposta ao Item, as propriedades dos itens desse instrumento foram analisadas por meio do Modelo de Crédito Parcial Generalizado. Oito dos vinte itens do instrumento original foram eliminados devido a baixos parâmetros de discriminação. Conforme esperado, os itens mais discriminantes na avaliação psiquiátrica foram aqueles de características afetivas típicas de traços de psicopatia, assim como sua maior variação reflete-se nas respostas a tais itens. A ancoragem de itens, por sua vez, permitiu a definição de cinco níveis âncora. Os resultados sugerem duas conclusões: (a) uma versão mais curta do instrumento pode oferecer níveis de informação similares aos do teste completo e (b) o instrumento é mais informativo em níveis médios de traço latente, sendo inadequado para uso clínico.

Estudio neuropsicológico de la dismorfia muscular y del trastorno obsesivo-compulsivo / Neuropsychological Study of Muscle Dysmorphia and Obsessive-Compulsive Disorder

Resumen El objetivo de este estudio fue explorar y comparar las funciones ejecutivas (FE) y la memoria no verbal de un grupo de varones fisicoconstructivistas con sintomatología de dismorfia muscular (DM), con un grupo de varones que presentan sintomatología del trastorno obsesivo-compulsivo (TOC) y un grupo de control. Aplicando pruebas neuropsicológicas se encontró que los fisicoconstructivistas muestran una capacidad limitada de las FE en el control inhibitorio y flexibilidad cognitiva, con déficits visuoespaciales moderados en la memoria no verbal, mientras que el grupo con TOC presentó mayores deficiencias de rendimiento en las mismas habilidades. Se sugiere realizar más estudios para evitar un conocimiento fragmentado o contradictorio entre la DM y el TOC.

Abstract The objective of this study was to explore and compare Executive Functions (EF) and non-verbal memory of a group of male bodybuilders who have symptoms of Muscle Dysmorphia (MD) with a group of men who have Obsessive Compulsive Disorder symptoms (OCD) and a control group. It was found by administering neuropsychological tests that the bodybuilders show a limited capacity of EF in the inhibitory control and cognitive flexibility, also moderate visuospatial deficits in non-verbal memory, whereas the group with OCD had higher performance deficiencies in the same skills. It is suggested to conduct more studies to avoid fragmented or contradictory knowledge between MD and OCD.

Environment, trauma and technical innovations: Three links between Donald W. Winnicott and Sándor Ferenczi / Ambiente, trauma e innovaciones técnicas: tres articulaciones entre Donald W. Winnicott y Sándor Ferenczi

Abstract Throughout this paper, the theoretical and clinical approaches of D.W. Winnicott are reviewed in order to reread the written production of Sándor Ferenczi. Winnicott's clinical and theoretical concepts allow returning to Ferenczi and rescuing aspects of his work that had been silenced in the psychoanalytic community. Ferenczi, in turn, is one that holds his presence in Winnicott's thought. Even though there are few times in which he cites Ferenczi in his work, it is possible to draw clear relationships between both theories. Three main issues are addressed: the role of the environment as active; the primitive traumatic event in which there is no one that has experience of it, and psychoanalysis as the place to experience that which happened in the first months of life for the first time; and, finally, severe pathologies and psychoses: technical innovations in Winnicott and Ferenczi for the treatment of psychotic and borderline patients. It is concluded that the theoretical and technical developments of Winnicott serve to illuminate a retrospective reading of Ferenczi.

Resumen A través de este trabajo, se retoman los planteamientos teóricos y clínicos de D.W. Winnicott para releer la producción escrita de Sándor Ferenczi. Los conceptos teóricos y clínicos de Winnicott permiten volver a Ferenczi y rescatar aspectos de su obra que habían quedado silenciados en la comunidad psicoanalítica. Ferenczi, a su vez, conserva su presencia en limítrofe el pensamiento de Winnicott. Si bien son escasas las veces que cita a Ferenczi en su obra, es posible trazar claros puntos de encuentro entre ambas teorías. Se abordan tres puntos principales: el papel del medio como activo, la vivencia traumática primitiva en la cual no hay un alguien que haga experiencia de ello y el psicoanálisis como el lugar para hacer experiencia por primera vez de eso que ocurrió en los primeros meses de vida y, por último, las enfermedades graves y la psicosis: innovaciones técnicas en Winnicott y Ferenczi para el tratamiento de pacientes psicóticos y borderline. Se concluye que los desarrollos teóricos y técnicos de Winnicott sirven para iluminar una lectura retrospectiva de Ferenczi.

Attachment Style and Resiliency in Patients with Obsessive-Compulsive Personality Disorder / 가정의학회지

BACKGROUND: The goal of the present study was to determine the relationships between attachment styles and resiliency in obsessive-compulsive personality disorder. METHODS: A random sample of 260 subjects was obtained from the population of undergraduate students of the Nour Branch of Islamic Azad University, which is located in Mazandaran, and these subjects were enrolled in this descriptive and correlational study. The collected data included the subjects' responses to an adult attachment style questionnaire, resilience scale, and obsessive-compulsive personality disorder questionnaire. The data were analyzed with Pearson correlation coefficient indices and multiple regressions. RESULTS: The results of the data analysis showed a positive correlation (relationship) between ambivalent/avoidant attachment styles and obsessive-compulsive personality disorder and a negative correlation between resilience and obsessive-compulsive personality disorder. Furthermore, these results demonstrated that attachment style and resiliency can predict obsessive-compulsive personality disorder. In addition, no significant relationships were found between the demographic variables (convertibles) and obsessive-compulsive personality disorder. CONCLUSION: These results suggested that attachment style and resiliency contribute to the development of obsessive-compulsive personality disorder.

O desenvolvimento do conceito de Pulsão de Morte na obra de Freud / The development of the concept of Death Drive of in Freud's work / El desarollo de el concepto de Pulsión de Muerte en la obra de Freud / Le développement de le concept de Pulsion de Mort dans l'oeuvre de Freud

Um dos temas metapsicológicos mais essenciais à obra freudiana é a teoria pulsional. Freud desenvolveu duas teorias - a primeira consistia em uma divisão das pulsões entre pulsões do ego e pulsões sexuais, enquanto a segunda propunha a existência de uma pulsão de morte, voltada à descatexização, e uma pulsão de vida, que buscava o investimento e a unificação. Sabendo que a segunda teoria criou bases para outro entendimento da agressividade, sadismo e masoquismo, e inclusive de psicopatologia, procura-se com este trabalho levantar hipóteses sobre o que levou Freud a modificar sua primeira teoria pulsional, e, desta maneira, tentar compreender tanto as bases que deram forma à segunda teoria pulsional, quanto à própria teoria. Conclui-se que o desenvolvimento do conceito de narcisismo, que unificou as pulsões sexuais e do ego, a retomada do princípio de constância e a compreensão da existência de uma compulsão a repetição foram os elementos que levaram Freud a propor uma nova forma de organizar as pulsões. Além disso, pode-se pensar em vivências pessoais pelas quais Freud passou e que contribuíram para uma mudança de pensamento, tais quais a Grande Guerra de 1914 a 1918 e a morte de sua filha Sophie, por volta de 1920.

One of the most essential metapsychological issues in the Freudian work is the drive theory. Freud developed two theories - the first consisted of a division between the ego drives and sexual drives, while the second proposed the existence of a death drive which focused on decathexization, and a Life Drive, seeking investment and unification. Knowing that the second theory created foundations for a different understanding of aggression, sadism and masochism, and even psychopathology, this work aims to hypothesize about what led Freud to change his first drive theory, and, in this way, try to understand both the foundations that shaped the second drive theory and the theory itself. It is concluded that the development of the concept of narcissism , that unified the sexual and ego drives, the resumption of the principle of constancy, and the understanding of the existence of a repetition compulsion were the elements that led Freud to propose a new way of organizing drives. Moreover, one can think of personal experiences in which Freud went through that contributed to a change in his thinking, such as the Great War of 1914 to 1918, and the premature death of his daughter Sophie, which happened around 1920.

Una de las cuestiones metapsicológicas más esenciales em la obra Freudiana es la teoría de las pulsiones. Freud desarrolló dos teorías - la primera consistió en una división de las Pulsiones entre pulsiones del yo y pulsiones sexuales, mientras que el segundo propone la existencia de una pulsión de muerte, centrada em lo desinvestimiento, y una pulsión de vida, en busca de investimiento y de unificación. Sabiendo que la segunda teoría crea bases para una comprensión diferente de la agresión, el sadismo y el masoquismo, y incluso la psicopatología, Este trabajo busca crear hipótesis sobre lo que llevó a Freud a cambiar su primera teoría de las pulsiones y proponer una nueva, y por lo tanto tratar de entender las bases que dieron forma a la segunda teoría de las pulsiones, y la teoría misma. Se concluye que el desarrollo del concepto de narcisismo - que unificó las pulsiones sexuales y del yo - la reanudación del principio de la constancia, y la comprensión de la existencia de una compulsión a la repetición es lo que finalmente llevó Freud a proponer una nueva forma de pensar organización de las pulsiones. Por otra parte, se puede pensar en experiencias personales de Freud que han contribuido a un cambio en el pensamiento ­ como la Gran Guerra de 1914 a 1918, y la muerte de su hija Sophie, alrededor de 1920.

L'un des principaux thèmes métapsychologiques le plus essentiel dans la psychanalyse est la théorie des pulsions. Freud a développé deux théories - la première consistait en une division entre les pulsion du moi et pulsion sexuelle - tandis que la seconde théorie proposait l'existence d'une pulsion de mort, responsable par le désinvestissement, et une pulsion de vie, celle-ci étant en quête d'investissements et d'unification. Puisque que la seconde théorie a créé des fondations pour une autre compréhension de l'agression, du sadisme et du masochisme, et même dela psychopathologie, ce travail cherche à comprendre ce qui a conduit Freud à abandonner sa première théorie des pulsions et à en proposer un nouvelle, et ainsi essayer de comprendre tantôt-les bases de la seconde théorie des pulsions, tantôt la théorie elle-même. On conclut que le développement de la notion de narcissisme, qui a unifié les pulsions sexuels et les pulsions du moi, la reprise du principe de constance, et la compréhension de l'existence d'une compulsion de répétition étaient ce que finalement conduit Freud à proposer une nouvelle façon de penser l'organisation de Pulsions. Qui plus est, on peut aussi penser à des expériences personnelles de Freud qui ont contribué à un changement de la pensée tel que la Grande Guerre de 1914 à 1918, et la mort de sa fille Sophie, autour de 1920.

Uma compreensão Fenomenológico-Hermenêutica das compulsões na atualidade / A phenomenological-hermeneutics comprehension of compulsions today

A proposta desse estudo é trazer outro modo de pensar as compulsões além daquela que as interpreta como algo da ordem de uma subjetividade encapsulada. Esse outro modo consiste em trilhar um caminho que denominamos de fenomenológico-hermenêutico. Acreditamos, com isso, poder abrir a possibilidade de se romper com os modelos previamente legitimados no campo da psicologia. Para tanto, procederemos a uma análise das compulsões nos pressupostos metodológicos da fenomenologia hermenêutica de Heidegger, partindo da ideia de que a existência humana se constrói na articulação copertinente com o mundo e viabilizando, assim, uma interpretação das compulsões no horizonte histórico da técnica.(AU)

The proposal of this study is to think about another way of thinking the compulsions beyond that which interprets this phenomenon as something on the order of subjectivity. This other way is to follow at a new path that here called phenomenological-hermeneutics. It to begin the templates previously legitimized in the field of psychology. We will review the compulsions and its disorders, inspired by the methodological assumptions of hermeneutics phenomenology of Heidegger. Your idea is that human existence is building in conjunction with the world, thus, an interpretation of the compulsions outside the contours of historical horizon of the technique.(AU)

Obsessive-compulsive (anankastic) personality disorder: toward the ICD-11 classification

Obsessive-compulsive personality disorder (OCPD) is an early-onset disorder characterized by perfectionism, need for control, and cognitive rigidity. Its nosological status is currently under review. Historically, OCPD has been conceptualized as bearing a close relationship with obsessive-compulsive disorder (OCD). In this article, we discuss the diagnosis of OCPD in anticipation of its review for the ICD-11, from the perspective of clinical utility, global applicability, and research planning. Considering the recent establishment of an obsessive-compulsive and related disorders (OCRD) category in DSM-5, we focus on the relationship between OCPD and the disorders that are currently thought to bear a close relationship with OCD, including DSM-5 OCRD, and other compulsive disorders such as eating disorder and autistic spectrum disorder (that were not included in the DSM-5 OCRD category), as well as with the personality disorders, focusing on nosological determinants such as phenomenology, course of illness, heritability, environmental risk factors, comorbidity, neurocognitive endophenotypes, and treatment response. Based on this analysis, we attempt to draw conclusions as to its optimal placement in diagnostic systems and draw attention to key research questions that could be explored in field trials.

Validez y confiabilidad de la Escala de Yale Brown versión niños y adolescentes (cy-bocs) en el Perú / Validity and reliability of Yale Brown's Scale version children and teenagers (cy-bocs) in Peru

Objetivo: Validar la Escala de Yale Brown versión niños y adolescentes (CY-BOCS) para trastorno obsesivo compulsivo (TOC) en niños y adolescentes peruanos. Método: 46 niños y adolescentes con diagnóstico de TOC (29 de sexo masculino y 17 de sexo femenino, entre 9 y 18 años) fueron evaluados con la escala CY-BOCS. A los 46 pacientes se les aplicó la escala en 2 oportunidades (test y re-test) y se grabó las entrevistas para que éstas sean puntuadas por 2 evaluadoras. La confiabilidad de la escala se determinó evaluando la correlación inter-evaluador, la correlación test/re-test y la consistencia interna. La validez se determinó con la correlación estadística entre los puntajes de la CY-BOCS y la ICG de severidad. Resultados: La confiabilidad total de la escala fue muy alta, el coeficiente de correlación inter-evaluador de Person fue de 95% y 97% para el test y re-test respectivamente; el coeficiente de correlación test-retest fue de 90%. La confiabilidad para obsesiones fue de 93% en el test y 96% en el re-test, y para las compulsiones de 97% en el test y 96 por ciento en el re-test. La consistencia interna fue muy buena, 87% para los 10 items. La validez de la prueba fue de 89% (test) y 83% (re-test). Conclusión: La CY-BOCS es una escala con alta confiabilidad y validez, y se constituye en un instrumento indispensable para la evaluación y seguimiento de todo niño y adolescente con TOC.

Objective: To validate Yale Brown Scale children and adolescents version (CY- BOCS) in Obsessive Compulsive Disorder (OCD) in peruvian children and adolescents. Method: 46 children and adolescents with OCD diagnosis (29 male and 17 female, between 9 and 18 years old) were evaluated using CY-BOCS. All 46 patients were tasted twice (test and retest) and the interviews were recorded in order to be scored by two examiners. The scale reliably was determined evaluating the correlation inter-examiner, correlation test-retest and the internal consistence.Results: The total scale reliably was high; the coefficient of correlation inter-examiner of Person was 95% for the test and 97% for the retest and, 90% for correlation test-retest. Obsessions reliably were percent and 96% for the retest, and the test compulsions reliably were 97% and 96% in the retest. Internal consistence was very good, 87% for 10 items. The test validity was 89% (test) and 83% (retest). Conclusion: CY-BOCS scale has a high reliably and validity and, it is an indispensable instrument for OCD children and adolescents following and evaluation.

specific pattern of obsessive-compulsive symptoms in patients with bipolar disorder

Some preliminary findings have suggested that patients with bipolar disorder show a disparate pattern of obsessive-compulsive [OC] symptoms. This study aimed to reevaluate this subject on a different sample within a different cultural background. The present cross-sectional study was carried out in a clinical non-experimental setting on 78 obsessive-compulsive disorder [OCD] patients; 39 with and 39 without bipolar disorder [BD]. Subjects underwent a Structured Clinical Diagnostic Interview for DSM-IV [SCID-I] as well as the Yale-Brown Obsessive-Compulsive Rating Scale [Y-BOCS]. The diagnoses in the non-bipolar group were mostly major depressive disorder [38%] and dysthymic disorder [38%]. The mean age of the bipolar group was significantly lower than that of the non-bipolars [P<0.05]. The mean score of the Y-BOCS was not significantly different between the two groups. The mean estimated number of obsessive themes - but not compulsive ones - in the bipolar group was significantly higher than that of the non-bipolars [P<0.0001]. The aggressive [P<0.01], sexual [P<0.0001] and religious [P<0.05] obsessions were significantly more prevalent, and the contamination obsession [P<0.05] was significantly less prevalent in the bipolar group. Also, in the bipolar group the miscellaneous compulsions [P<0.01] were significantly more prevalent, and the washing compulsion [P<0.001] was significantly less prevalent. The content of OC symptoms which is not traditionally considered a helpful factor for diagnosing a psychiatric disorder might be able to lead the clinician to the diagnosis of bipolarity in a depressed patient with OCD

Terapia Cognitiva en Pacientes Pediátricos con / Trastorno Obsesivo Compulsivo / Cognitive Therapy in Pediatric Obsessive Compulsive Disorder

En las últimas dos décadas, la Terapia Cognitiva Comportamental (TCC) se afianzó como el tratamiento de elección para el Trastorno Obsesivo Compulsivo (TOC). Sin embargo, hasta hace pocos años se desconocía su utilidad en población infantil y adolescente. Afortunadamente, en forma paulatina, se fueron efectuando una variedad de investigaciones que arrojan resultados altamente positivos. De hecho, los datos concuerdan en señalar la eficacia de la TCC en el tratamiento de pacientes pediátricos con TOC. El presente artículo reseña las características principales que presenta el cuadro en población infantil, datos epidemiológicos y aspectos relacionados con la comorbilidad. Además, se comentan los resultados de las investigaciones más relevantes efectuadas hasta la fecha y se esbozan las características generales del abordaje psicoterapéutico.

Superego contemporâneo: exceção e regra / Superego nowadays – exception and rule

Este artigo tem por objetivo discutir a clínica contemporânea considerando o declínio dos ideais morais no campo cultural em sua relação com o recalque e o superego. A partir da constatação de que as subjetividades dos dias de hoje apresentam uma prevalência do imaginário sobre a capacidade simbólica, a intensificação dos vícios, atuações e compulsões, concluímos que a perversão é uma estrutura predominante na cultura. Assim sendo, o superego em sua vertente tirânica, determinando um empuxo ao gozo em associação à pulsão de morte, encontra-se mais fortalecido do que em sua relação com recalque. A clínica proposta por Lacan, em que se estabelecem suplências para equilibrar subjetividades nas quais o significante Nome-do-pai esteve ausente, permite incluir no discurso analítico, casos em que a metaforização do falo não se deu de forma suficiente. Apresentamos um caso clínico visando ilustrar essa prática.

Transtorno de ansiedade obsessivo-compulsivo (TOC) e transtorno da personalidade obsessivo-compulsivo (TPOC): um diagnóstico analítico-comportamental / Obsessive-compulsive disorders (OCD) and the obsessive-compulsive personality disorders (OCPD): a behavior-analytic

O Transtorno de Ansiedade Obsessivo-Compulsivo (TOC) e o Transtorno da Personalidade Obsessivo-Compulsiva (TPOC) mostram congruências conceituais que historicamente têm confundido o diagnóstico de muitos pesquisadores e clínicos. Em parte, as ambigüidades provavelmente ocorrem devido aos equívocos muitas vezes apresentados pelos instrumentos diagnósticos e também pelo despreparo profissional. A outra fração de erros certamente acontece devido à grande semelhança entre os fenômenos comportamentais. Pela pertinência clínica que o questionamento traz, faz-se mister um aprofundamento teórico. O objetivo deste ensaio foi analisar, sob os pressupostos do behaviorismo radical, o caso de uma cliente atendida durante o estágio clínico. A partir da análise, lançou-se a hipótese sobre a existência de uma semelhança entre as variáveis operantes nos comportamentos obsessivo-compulsivos de ambos os transtornos. Concluiu-se que a semelhança fenomenológica ocorre não pelas topografias comportamentais vigentes, mas pela similaridade existente entre as variáveis de controle

Bereitschaftspotential in tic disorders: a preliminary observation.

Sensory phenomena in tic disorders such as Tourette's syndrome are known but are substantiated by only a handful of studies. In this preliminary report, we studied premonitory urge, a type of sensory phenomenon in three patients of tic disorders. Bereitschaftspotential, a movement-related cognitive potential indicative of motor preparation, was assessed in these patients. As bereitschaftspotential was observed in all our cases prior to occurrence of tics, it is speculated that tics are not entirely involuntary but are quasi-volitional in nature. Bereitschaftspotential may thus represent a neurophysiological marker of premonitory urge in tic disorders. Implications of exploring the voluntary nature of tics are discussed.

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder(OCD) is characterized by recurrent obsessions or compulsions causing marked distress. The lifetime prevalence of OCD in general population is estimated about 2~3%. OCD can usually be distinguished from psychosis by the facts that the patients recognize the irrational nature of the symptoms. OCD is also different from obsessive-compulsive personality in that the patients suffer from obsessions and compulsions which accompany marked distress. The etiology of OCD is not know yet. However, numerous studies suggest that OCD may be associated with several psychological and neurobiological factors such as functional abnormalities of cortico-striatal circuit and serotonin. Selective serotonin reuptake inhibitors(SSRI) are the first-line drugs for the treatmemt of OCD. Approximately 50~80% of OCD patients improved with these anti-obsessional drugs with average reduction in symptoms between 30~70%. Benefits may not appear for 2 or more weeks. Continuing a medication for more than 10 weeks is required to determine the anti-obsessional efficacy. Maintenance treatment is usually required for more than several months. Cognitive-behavioral therapy also proved to be effective, particularly for patients with prominent compulsions. Therefore, it is a logical choice to combine pharmacotherapy and cognitive-behavioral therapy. For extreme cases electroconvulsive therapy(ECT) or stereotaxic neurosurgery may be considered. However, at present, neurosurgery is recommended only for a few patients who remained severely disabled even after years of sufficient treatments.

Aspectos de personalidade e comorbidades em um caso de transtorno alimentar de longa evolucao / Personality disorder and comorbidities in a case of eating disorder of long duration

Relatamos um caso de transtorno alimentar que apresentou comorbidade com outros transtornos psiquiatricos tais como evolucao atipica de bulimia nervosa de duracao de 18 anos para anorexia nervosa...

A Study on the Types of Alcohol Dependence by Alcohol Use Inventory and Their Characteristics / 신경정신의학

OBJECTIVES: The purpose of this study is to classify the type of individuals with alcohol dependence, and to examine its clinical characteristics through cluster analysis. METHODS: 180 inpatients with alcohol dependence were examed with AUI, MAST, ADS, and MCMI. The classification of alcohol dependence was done through the cluster analysis. RESULTS: 1) Patients with alcohol dependence could be classified into three types. Type 1 of alcohol dependence was the severest in terms of physical and psychological dependence on alcohol, alcohol-related problems, and loss of control, and was characterized by isolated drinking and binge drinking. Type 2 of alcohol dependence was mainly drinking on account of personal relationships, and is characterized by continuous drinking. Type 3 of alcohol dependence is relatively the mildest type, which led to withdrawal symptoms and complications. 2) There is no difference in age, educational level, marital status, occupation, family history of alcoholism among three types. 3) As a result of comparative analysis of age at the first hospitalization by drinking, physical and psychological dependence on alcohol, complications by drinking, amount of drinking, and frequency of drinking, the age at the first hospitalization by drinking showed statistically significant difference between type 1 and type 2 or type 3. 4) There was a significant difference in anti-social personality trait, borderline personality trait, and obsessive-compulsive personality trait, and drug abuse tendency between type 3 and type 1 or type 2. There was a significant difference in the degree of depression between type 1 and type 3; there was no difference in the degree of anxiety among three types. CONCLUSION: It is possible to classify alcohol dependence into three types by means of AUI in Korea, and each type should require specific models of therapeutic strategies and approaches in accordance with its clinical characteristics.

Escalas de avaliacao de transtorno obsessivo-compulsivo na infancia e adolescencia / Rating scales for obsessive compulsive disorder in children and adolescents

Instrumentos especificos de avaliacao de sintomas obsessivo-compulsivos (SOC) em criancas e adolescentes sao escassos, sendo derivados de versoes originalmente desenvolvidas para adultos. Vantagens e limitacoes dos principais instrumentos utilizados para avaliacao dos diversos tipos de SOC e sua intensidade, as versoes para criancas do inventario de obsessoes de Leyton de 44 itens e da escala Yale-Brown de obsessoes e compulsoes, sao discutidas. Por fim, ressalta-se a utilizacao da escala global de obsessoes e compulsoes do NIMH como medida secundaria de gravidade de SOC

Abordaje cognitivo-comportamental y farmacológico del trastorno obsesivo-compulsivo / Cognitive, behavioral and pharmacologic approach to obsessive compulsive disorder

Se define según el Manual diagnóstico y estadístico de los trastornos mentales IV (DSM-IV), el trastorno obsesivo-compulsivo (Eje I) y el trastorno obsesivo-compulsivo de personalidad (Eje II), señalando sus relaciones. Se enumeran los trastornos asociados más frecuentes, así como los factores relacionados con la génesis y mantenimiento. Se describen los instrumentos de medida usados en la instancia de evaluación, diagnóstico y análisis funcional. Con relación al tratamiento se elige la asociación de fármacos y terapia cognitivo-comportamental. En cuanto a los fármacos se jerarquiza el uso de la clorimipramina, fluoxetina, sertralina y su asociación con neurolépticos, benzodiacepinas, carbamacepina y sales de litio, si el caso lo requiere. Las estrategias cognitivo-comportamentales se seleccionan ajustandose a los diagnósticos realizados en los ejes I y II. En el caso de las rumiaciones obsesivas las técnicas más desarrolladas son la detención del pensamiento, la saturación y las cognitivas. Para los rituales, la técnica principal es la exposición con prevención de la respuesta ritualizada. Para el trastorno obsesivo-compulsivo de personalidad se trabaja con las estrategias cognitivas propuestas por A. Beck y A Freeman. Se citan ejemplos de casos asistidos en el centro de atención profilactica y terapéutica de adolescentes y adultos (CAPTA)

Distúrbio obsessivo-complusivo: características sócio-demográficas e clínicas de 50 pacientes através de seus prontuários: terceira parte: diagnóstico diferencial e comorbidade / Obsessive-compulsive disorder (OCD): the social-demographic and clinical characteristics of 50 patients

O distúrbio obsessivo-compulsivo (DOC) é um dos quadros psiquiátricos de mais difícil compreensão. Os estudos que caracterizam os pacientes adultos em DOC são poucos e esse número é ainda mais limitado quando nos referimos a pacientes com diagnóstico de DOC pelo DSM-III-R. Diante disso, o presente estudo foi realizado com o objetivo de descrever as características sócio-demográficas e clínicas de 50 pacientes. apesar das limitações do nosso estudo, os resultados foram, em geral, consistentes com os achados prévios da literatura, mostrando uma consistência entre as culturas