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.

Tics, obsesiones y síndrome de Gilles de la Tourette: actualización clínica / Tics, obsessions and Tourette's syndrome: a clinical update

El síndrome de La Tourette es un transtorno caracterizado por la presencia de movimiento involuntarios (tics motores) y vocalizaciones (tics vocales). Frecuentemente asociado a transtorno obsesivo compulsivo y déficit atencional. Presenta una distribución mundial pero en nuestro medio existen escasas comunicaciones. Se comunican los avances en la fisiopatología y tratamiento de este transtorno y se discute la evidencia actual que plantea la presencia de desinhibición de los circuitos neuronales córticos-subcorticales en la fisiopatología de este cuadro. El Síndrome de la Tourette constituye un verdadero paradigma para un mejor entendimiento de la estrecha relación existente entre la actividad cognitivo-emocional y la función motora. Este cuadro es bastante común y no frecuente reconocido como tal en nuestro medio