ABSTRACT
BACKGROUND: Our objective is to report the prevalence and the clinical features associated with body dysmorphic disorder (BDD) and eating disorders (ED) in a group of elite Brazilian professional female ballet dancers. METHODS: Thirty-five elite Brazilian professional female ballet dancers were invited to participate in the study and 19 agreed to be assessed. Individuals were evaluated with a series of instruments, including the Mini International Neuropsychiatric Interview supplemented by the somatoform and eating disorders modules of the Structured Clinical Interview for DSM-IV disorders, the Bulimic Investigatory Test, and the Beck Depression Inventory. RESULTS: Three dancers (15.78%) had a lifetime diagnosis of anorexia nervosa (restrictive subtype) and 2 others (10.52%) presented a current diagnosis of BDD. No individuals had current or lifetime bulimia nervosa. Results could not be ascribed to comorbid major depression or increased severity of depression. CONCLUSION: The lifetime prevalence of BDD and ED among elite professional female ballet dancers was higher than the general population. High standards of beauty, public body exposure, and repeated exposure to mirrors in the rehearsal rooms may contribute to the development of body image disorders in this sample.
Subject(s)
Anorexia Nervosa/epidemiology , Body Dysmorphic Disorders/epidemiology , Bulimia Nervosa/epidemiology , Dancing/psychology , Adult , Beauty , Body Image/psychology , Body Mass Index , Brazil/epidemiology , Cross-Sectional Studies , Female , Humans , Occupations , PrevalenceABSTRACT
OBJECTIVE: There is mixed evidence as to whether patients with obsessive-compulsive disorder (OCD) have excessive attentional engagement and emotional response to OCD-related stimuli in the environment. Here we investigate the occurrence of an attentional bias toward specific OCD-related stimuli and its relationship with obsessive-compulsive symptom dimensions. METHODS: Forty-eight patients with OCD participated in an attentional bias task containing OCD- and non-OCD-related stimuli and had their performance compared with that of 24 age-, sex-, and education-matched healthy control subjects. Severity of obsessive-compulsive and comorbid depressive symptoms was assessed using the Obsessive-Compulsive Inventory-Revised and the Beck Depression Inventory, respectively. RESULTS: Although there were significant and almost significant group effects on the reaction time (RT) toward OCD- and non-OCD-related figures, respectively, no difference between patients with OCD and controls was noted with regard to RT toward OCD-related figures minus RT toward non-OCD-related figures. Nevertheless, within the OCD group, partial correlational analysis controlled for age and severity of depression unveiled positive correlations between (1) obsessional symptoms and RT toward checking-related pictures and (2) ordering symptoms and RT toward ordering-related pictures. CONCLUSIONS: The positive correlations between RT to content-specific stimuli and the severity of corresponding obsessive-compulsive symptoms suggest that patients with OCD experience difficulty in disengaging attention from personally salient stimuli.
Subject(s)
Attention/physiology , Depression/psychology , Emotions/physiology , Obsessive-Compulsive Disorder/psychology , Adolescent , Adult , Aged , Cues , Depression/complications , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Obsessive-Compulsive Disorder/complications , Photic Stimulation , Psychiatric Status Rating Scales , Reaction Time/physiology , Severity of Illness IndexABSTRACT
INTRODUÇÃO: A identificação do viés cognitivo no Transtorno Obsessivo-Compulsivo (TOC) permanece inconclusiva. Uma área de interesse potencial inclui a verificação do processamento visual e desempenho de memória implícita. OBJETIVOS: Selecionar estímulos visuais para inclusão em uma versão do Teste de Associação Implícita (TAI) para o TOC. MÉTODOS: Dezessete pacientes com TOC e 17 controles saudáveis avaliaram 12 estímulos visuais relacionados a diferentes dimensões dos sintomas obsessivo-compulsivos e classificaram os estímulos de acordo com dois critérios: "tipo de impacto" (i.e., positivo, negativo ou neutro) e "grau de impacto" [i.e., 1 (baixo impacto) a 5 (alto impacto)]. Nos testes qui-quadrado e Mann-Whitney, foi utilizado nível de significância de 0.05. RESULTADOS: Pacientes com TOC avaliaram 9 dos 12 estímulos visuais diferente dos controles saudáveis, em pelo menos um dos dois critérios. Discussão: O achado de que as figuras empregadas foram capazes de diferenciar pacientes de controles saudáveis sugere sua inclusão no desenvolvimento de instrumentos de avaliação psicopatológica, como o TAI-TOC.
INTRODUCTION: The identification of cognitive bias in Obsessive-Compulsive Disorder (OCD) remains inconclusive. An area of potential interest includes the examination of visual processing and implicit memory performance. OBJECTIVES: Select visual stimuli to include in a version of the Implicit Association Test (IAT) for OCD. METHODS: Seventeen patients with OCD and 17 healthy controls evaluated 12 visual stimuli related to different dimensions of obsessive-compulsive symptoms and classified the stimuli according to two criteria: "type of impact" (i.e., positive, negative or neutral) and "degree of impact" [i.e., 1 (low impact) to 5 (high impact)]. The chi-square and the Mann-Whitney tests were employed and the level of significance at 0.05. RESULTS: OCD patients evaluated 9 out of the 12 stimuli different from healthy controls in at least one of the two criteria. DISCUSSION: The finding that the figures employed were able to differentiate OCD patients from healthy controls suggests their inclusion in the psychopathological assessment development tools, such as the IAT-OCD.
Subject(s)
Photic Stimulation/methods , Evaluation Studies as Topic , Obsessive-Compulsive Disorder/diagnosis , Cognition Disorders/diagnosis , Memory DisordersABSTRACT
INTRODUÇÃO: A insatisfação com a imagem corporal é uma das características mais proeminentes do transtorno dismórfico corporal (TDC) e dos transtornos alimentares (TA). Esses dois grupos de transtornos apresentam semelhanças em suas características psicopatológicas e epidemiológicas e na resposta ao tratamento. Apesar de ambos serem considerados transtornos do espectro obsessivo-compulsivo, pouco se sabe em relação à comorbidade entre esses dois grupos de transtornos. OBJETIVO: Avaliar a produção bibliográfica atual sobre a comorbidade entre TDC e TA. MÉTODO: Foi realizada uma revisão sistemática nos bancos de dados PubMed e ISI Web of Science dos artigos referentes à comorbidade entre TDC e TA. RESULTADOS: Oito artigos foram selecionados. As amostras de portadores de TA apresentavam comorbidade com TDC em 6 por cento a 39 por cento dos casos. Dos pacientes com TDC, 10 por cento a 32,5 por cento, por sua vez, podem apresentar comorbidade com TA. O TDC frequentemente precedia o TA, e os pacientes com comorbidade apresentavam quadro clínico mais grave que os com apenas um dos transtornos. CONCLUSÃO: Estudos recentes demonstram que as taxas de comorbidade entre esses dois transtornos são elevadas. Apesar disso, o TDC raramente é diagnosticado em portadores de TA, mesmo quando é o transtorno que causa mais incômodo.
BACKGROUND: Body image dissatisfaction is one of the most prominent psychopathological features of body dysmorphic disorder (BDD) and eating disorders (ED). These groups of disorders present similarities in psychopathological and epidemiological features and also in response to treatment. Although these disorders are included in the obsessive-compulsive spectrum, little is known about the comorbidity between the two groups of disorders. OBJECTIVE: To evaluate the current bibliographic production on the comorbidity of BDD and ED. METHOD: A systematic review has been conducted on the PubMed and ISI Web of Science databases. RESULTS: Eight articles have been selected. These articles report that patients with ED may present comorbidity with BDD in 6 percent to 39 percent of the cases. 10 percent to 32.5 percent of the patients with BDD might present comorbidity with a TA. BDD preceded ED in the majority of the patients with comorbidity and patients with both disorders had more severe presentations than patients with either disorder alone. CONCLUSION: Recent studies have shown that comorbidity ratios between these disorders are high. However, BDD is seldom diagnosed in patients with ED, even when it is the most severe disorder.
Subject(s)
Body Image , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/epidemiology , Body Dysmorphic Disorders/diagnosis , Body Dysmorphic Disorders/epidemiology , Brazil , Comorbidity , Feeding Behavior , PrevalenceABSTRACT
OBJETIVO: O Jornal Brasileiro de Psiquiatria (JBP) é um periódico especializado em psiquiatria editado desde 1938 e que publica boa parte da produção científica brasileira nesta área. O objetivo deste artigo é fazer uma análise bibliométrica dos artigos publicados no JBP entre 1995 e 2004. MÉTODOS: Os artigos publicados no JBP neste período foram classificados quanto ao ano de publicação, à origem geográfica (de acordo com a afiliação do primeiro autor) e ao tipo de artigo (artigos de revisão, pesquisas originais, relatos de caso, metanálises e artigos opinativos). Foram analisados os números absolutos e proporcionais de artigos publicados por cada estado brasileiro e as contribuições internacionais e os tipos de artigos, considerando-se toda a década estudada e também cada qüinqüênio. RESULTADOS: Foram publicados 619 artigos no período estudado, sendo 91,4 por cento destes de autores brasileiros. Os estados com maior número de publicações foram: Rio de Janeiro, São Paulo, Minas Gerais, Rio Grande do Sul e Pernambuco. Os artigos de pesquisa e de revisão predominaram no período estudado (37,3 por cento e 35,9 por cento, respectivamente). CONCLUSÃO: Houve uma mudança no perfil dos artigos publicados no JBP ao longo do período estudado, com maior diversidade de origem de artigos no segundo qüinqüênio. Isto pode refletir uma maior visibilidade do JBP.
OBJECTIVE: The Jornal Brasileiro de Psiquiatria (JBP) is a scientific journal specialized in psychiatry edited since 1938, publishing part of the Brazilian scientific production in this area. This paper aims at producing a bibliometric analysis of the articles published at the JBP from 1995 to 2004. METHODS: The articles have been classified according to their year of publication, geographic origin (according to the scientific affiliation of the first author), type of article (review articles, original research, case reports, meta-analysis and opinative articles). The absolute and proportional numbers of articles in each category were analyzed considering the whole decade and the two studied quinquenniums. RESULTS: 619 articles were published at the JBP on this period. 91.4 percent of these were written by Brazilian researchers. Rio de Janeiro, São Paulo, Minas Gerais, Rio Grande do Sul and Pernambuco were the top Brazilian states in number of published articles. Original research and review articles were the most frequent publications (37.3 percent e 35.9 percent, respectively). CONCLUSION: From 1995 to 2004 the profile of the articles published at the JBP changed, with greater geographic diversity on the second quinquennium. This might reflect the greater visibility of the JBP.
ABSTRACT
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.
Subject(s)
Socioeconomic Factors , Somatoform Disorders/epidemiology , Brazil , Chronic Disease , Comorbidity , Compulsive Behavior/diagnosis , Compulsive Behavior/epidemiology , Compulsive Behavior/psychology , Cross-Cultural Comparison , Cross-Sectional Studies , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/psychology , Follow-Up Studies , Humans , Obsessive-Compulsive Disorder/diagnosis , Obsessive-Compulsive Disorder/epidemiology , Obsessive-Compulsive Disorder/psychology , Retrospective Studies , Somatoform Disorders/diagnosis , Somatoform Disorders/psychologyABSTRACT
BACKGROUND: Although there are some reports on the efficacy of maintenance electroconvulsive therapy (mECT) in rapid cycling bipolar disorder there is scant data about the use of mECT in the non-rapid cycling form of this condition. PATIENT AND METHODS: We report the case of a 45-year-old man diagnosed with bipolar affective disorder at the age of 32 who had 5 manic episodes in 6 years. These episodes were severe, required hospitalization and had poor response to lithium carbonate, sodium valproate, carbamazepine, haloperidol and chlorpromazine (either alone or in combination). The patient was treated with electroconvulsive therapy (ECT) during his last hospitalization and since then his treatment has included mECT and chlorpromazine (400 mg/day) and he has remained euthymic during the past 21 months. CONCLUSION: This case describes the utility of mECT in medication refractory bipolar disorder.
Subject(s)
Bipolar Disorder/therapy , Electroconvulsive Therapy/methods , Antipsychotic Agents/therapeutic use , Bipolar Disorder/drug therapy , Bipolar Disorder/rehabilitation , Drug Resistance , Hospitalization/statistics & numerical data , Humans , Lithium Carbonate/therapeutic use , Male , Middle Aged , RecurrenceABSTRACT
Objetivo: propor um modelo estruturado para elaboração das respostas às solicitações de pareceres psiquiátricos no hospital geral e discutir seus aspectos fundamentais. Métodos: foi realizada uma pesquisa sistemática nas bases de dados PubMed/Medline e PsycINFO à procura de artigos que descrevessem modelos para a resposta aos pareceres psiquiátricos em hospitais gerais. Além disso, todos os artigos sobre psiquiatria de ligação publicados no Jornal Brasileiro de Psiquiatria (indexado no PsycINFO) nos últimos dez anos foram analisados para localizar as contribuições brasileiras o tema. Foram selecionados artigos que descrevessem modelos estruturados para as respostas às solicitações de pareceres psiquiátricos em hospitais gerais. As informações contidas nesses artigos foram usadas na construção de uma proposta de ficha de parecer psiquiátrico. Resultados: apenas dois artigos preenchiam os critérios de seleção. Outros cinco artigos que descreviam problemas no processo de consultoria psiquiátrica forneceram informações sobre questões que deveriam ser abordados nos pareceres. Os modelos de parecer descritos foram analisados, e um novo modelo foi desenvolvido. Conclusão: os pareceres psiquiátricos são documentos que atendem às necessidades médicas e educacionais em um hospital geral. Um modelo estruturado de parecer evita a omissão de informações importantes, melhorando a comunicação entre os psiquiatras pareceristas e os outros médicos no hospital geral.
