Assuntos
Antipsicóticos/efeitos adversos , Clozapina/uso terapêutico , Distonia/induzido quimicamente , Doenças da Laringe/induzido quimicamente , Esquizofrenia/tratamento farmacológico , Distúrbios da Voz/induzido quimicamente , Adulto , Antipsicóticos/uso terapêutico , Relação Dose-Resposta a Droga , Esquema de Medicação , Distonia/tratamento farmacológico , Feminino , Humanos , Doenças da Laringe/tratamento farmacológico , Exame Neurológico/efeitos dos fármacos , Resultado do Tratamento , Distúrbios da Voz/tratamento farmacológicoRESUMO
The aim of this study was to evaluate the degree of insight and resistance in a sample of obsessive-compulsive patients, and the predictive value of poor insight with respect to response to treatment with serotonin reuptake inhibitors (SRIs). Ninety-three patients fulfilling DSM-IV criteria for obsessive-compulsive disorder were evaluated. Seventy patients were treated with an SRI in a 24-week open-label trial. Sixteen percent of the patients did not recognize obsessions and compulsions as unreasonable or senseless. Fifty-two percent of the patients did not try to resist, 72% had little or no control over obsessions, and 64% were not able to exercise an effective control over compulsions. Patients with poor insight had a greater severity of obsessive-compulsive symptoms, a higher rate of schizophrenia spectrum disorders in their first-degree relatives and a higher frequency of a history of psychiatric disorders during childhood. Fifty-two percent of the patients with normal insight responded to SRIs, whereas none of the patients with poor insight were found to be responders. These results suggest the utility of the assessment of insight and resistance in obsessive-compulsive patients, also for the prediction of response to treatment with SRIs.
