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Trastorno obsesivo compulsivo: influencia de la edad de inicio en el tipo de enfermedades coexistentes

Published online by Cambridge University Press:  12 May 2020

María Alice de Mathisad
Affiliation:
Departamento de Psiquiatría, Facultad de Medicina, Universidad de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 785, 05403-010Sao Paulo, SP, Brasil Consorcio Brasileño del Trastorno Obsesivo Compulsivo (C-TOC)
María Conceição do Rosarioa
Affiliation:
Departamento de Psiquiatría, Facultad de Medicina, Universidad de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 785, 05403-010Sao Paulo, SP, Brasil Consorcio Brasileño del Trastorno Obsesivo Compulsivo (C-TOC) Departamento de Psiquiatría, Universidad Federal de Sao Paulo, Brasil
Juliana Belo Diniz
Affiliation:
Departamento de Psiquiatría, Facultad de Medicina, Universidad de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 785, 05403-010Sao Paulo, SP, Brasil Consorcio Brasileño del Trastorno Obsesivo Compulsivo (C-TOC)
Albina Rodrigues Torres
Affiliation:
Departamento de Neurología y Psiquiatría, Facultad de Medicina Botucatu, Brasil Consorcio Brasileño del Trastorno Obsesivo Compulsivo (C-TOC)
Roseli Gedanki Shavitt
Affiliation:
Departamento de Psiquiatría, Facultad de Medicina, Universidad de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 785, 05403-010Sao Paulo, SP, Brasil Consorcio Brasileño del Trastorno Obsesivo Compulsivo (C-TOC)
Ygor Arzeno Ferrão
Affiliation:
Centro Universitario Instituto Porto Alegre, Brasil Consorcio Brasileño del Trastorno Obsesivo Compulsivo (C-TOC)
Victor Fossaluza
Affiliation:
Departamento de Psiquiatría, Facultad de Medicina, Universidad de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 785, 05403-010Sao Paulo, SP, Brasil Instituto de Matemáticas y Estadística de Brasil, Universidad de Sao Paulo, Brasil
Carlos Alberto de Bragança Pereira
Affiliation:
Instituto de Matemáticas y Estadística de Brasil, Universidad de Sao Paulo, Brasil
Eurípedes Constantino Migue
Affiliation:
Departamento de Psiquiatría, Facultad de Medicina, Universidad de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 785, 05403-010Sao Paulo, SP, Brasil Consorcio Brasileño del Trastorno Obsesivo Compulsivo (C-TOC)
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Resumen

Objetivo

En este estudio se investiga la influencia de la edad de inicio de los síntomas obsesivos-compulsivos (SOC) sobre las enfermedades psiquiátricas coexistentes, y trata de establecer un valor de corte para la edad de inicio.

Métodos

Trescientos treinta pacientes con TOC se seleccionaron y entrevistaron consecutivamente usando las siguientes entrevistas estructuradas: Escala Obsesiva Compulsiva Yale-Brown; Escala Global de Gravedad de Tics de Yale y Entrevista Clínica Estructurada del DSM-IV. Los datos se analizaron por análisis en racimo y de regresión.

Resultados

La edad menor de inicio de la enfermedad se asoció con una mayor probabilidad de coexistencia de trastornos de tics, ansiedad, somatomorfo, de la alimentación y del control de impulsos. La mayor duración de la enfermedad se asoció con menos posibilidades de tener tics. El sexo femenino se asoció con trastornos de ansiedad, de la alimentación y del control de impulsos. Los trastornos de tics se asociaron con trastornos de ansiedad y trastorno de déficit de atención/hiperactividad (TDAH). No se encontró ningún valor de corte de la edad de inicio de la enfermedad para dividir claramente la muestra en subgrupos homogéneos. Sin embargo, los análisis en racimo revelaron que comenzaban a surgir diferencias a los 10 años y eran más pronunciadas a los 17 años, lo que indica que éstos son los mejores valores de corte de esta muestra.

Conclusiones

En pacientes con TOC, la edad de inicio se asocia con patrones específicos de enfermedades coexistentes. Las diferencias más notables se obtienen analizando la edad de inicio como valor absoluto.

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 2008

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References

Bibliografía

[1]Ackerman, DLGreenland, SBystritsky, AMorgenstem, HKatz, RJPredictors of treatment response in obsessive—compulsive disorder: multivariate analyses from a multicenter trial of clomipramine. J Clin Psychopharmacol 1994;14(4):247–54.CrossRefGoogle ScholarPubMed
[2]Ackerman, DLGreenland, SBystrisky, AClinical characteristics of response to fluoxetine treatment of obsessive—compulsive disorder. J Clin Psychopharmacol 1998; 18(3): 185–92.CrossRefGoogle ScholarPubMed
[3]Albert, UPicco, CMaina, GForner, FAguglia, EBogetto, FPhenomenology of patients with early and adult onset obsessive—compulsive disorder. Epidemiol Psichiatr Soc 2002;11(2): 116–26.CrossRefGoogle ScholarPubMed
[4]Alonso, PMenchon, JMPifarre, JMataix-Cols, DTorres, LSalgado, P et al. Long-term follow-up and predictors of clinical outcome in obsessive—compulsive patients treated with serotonin reuptake inhibitors and behavioral therapy. J Clin Psychiatry 2001;62(7):535–40.CrossRefGoogle ScholarPubMed
[5]Bienvenu, OJSamuels, JFRiddle, MAHoehn-Saric, RLiang, KYCallen, BA et al. The relationship of obsessive—compulsive disorder to possible spectrum disorders: results from a family study. Biol Psychiatry 2000 Aug 15;48(4):287–93.CrossRefGoogle ScholarPubMed
[6]Bogetto, FVenturello, SAlbert, UMaina, GRavizza, LGender-related clinical differences in obsessive—compulsive disorder. Eur Psychiatry 1999 Dec;14(8):434–41.CrossRefGoogle ScholarPubMed
[7]Busatto, GFBuchpiguel, CAZamignani, DRGarrido, GEGlabus, MFRosario-Campos, MC et al. Regional cerebral blood flow abnormalities in early-onset obsessive—compulsive disorder: an exploratory SPECT study. J Am Acad Child Adolesc Psychiatry 2001;40(3):347–54.CrossRefGoogle ScholarPubMed
[8]Cameron, OGHill, EMWomen and anxiety. Psychiatr Clin North Am 1989;12(1):175–86 [review].CrossRefGoogle ScholarPubMed
[9]Castle, DJDeale, AMarks, IMGender differences in obsessive— compulsive disorder. Aust N Z J Psychiatry 1995 Mar;29(1):114–7.CrossRefGoogle ScholarPubMed
[10]Chabane, NDelorme, RMillet, BMouren, MCLeboyer, MPauls, DEarly obsessive—compulsive disorder: a subgroup with specific clinical and familial pattern? J Child Psychol Psychiatry 2005;46(8): 881–7.CrossRefGoogle ScholarPubMed
[11]Coffey, BJMiguel, ECBiederman, JBaer, LRauch, SLO'Sullivan, RL et al. Tourettets disorder with and without obsessive—compulsive disorder in adults: are they different? J Nerv Ment Dis 1998 Apr;186(4):201–6.CrossRefGoogle ScholarPubMed
[12]Delorme, RGoldmard, JLChabane, NMillet, BKrebs, MOMouren-, Simeoni MC et al. Admixture analysis of age of onset in obsessive— compulsive disorder. Psychol Med 2005;35(2):237–43.CrossRefGoogle ScholarPubMed
[13]DeVeaugh-Geiss, JKatz, R, Landau, P, Landau, P, Goodman, W, Rasmussen, S. Clinical predictors of treatment response in obsessive compulsive disorder: exploratory analyses from multicenter trials of clomipramine. Psychopharmacol Bull 1990;26(1):54–9.Google ScholarPubMed
[14]Diniz, JBRosário-Campos, MCShavitt, RGCari, MHounie, AGBrotto, SA et al. Impact of age at onset and duration of illness on the expression of comorbidities in obsessive—compulsive disorder. J Clin Psychiatry 2004;65(1):22–7.CrossRefGoogle ScholarPubMed
[15]Diniz, JBRosário-Campos, MCHounie, AGCari, MShavitt, RGLopes, AC et al. Chronic tics and Tourette syndrome in patients with obsessive—compulsive disorder. J Psychiatr Res 2006;40(6):487–93.CrossRefGoogle ScholarPubMed
[16]Fahy, TAOsacar, AMarks, IHistory of eating disorders in female patients with obsessive—compulsive disorder. Int J Eat Disord 1993 Dec; 14(4):439–43.3.0.CO;2-6>CrossRefGoogle ScholarPubMed
[17]Ferrao, YAShavitt, RGBedin, NRde Mathis, MECarlos, Lopes AFontenelle, LF et al. Clinical features associated to refractory obsessive— compulsive disorder. J Affect Disord 2006;94(1-3): 199209.CrossRefGoogle ScholarPubMed
[18]First, MBSpitzer, RLGibbon, MWilliams, JBWStructural clinical interview for DSM-IV axis I disorders, patient edition (SCID-P), version 2. New York: New York State Psychiatric Institute, Biometrics Research; 1995.Google Scholar
[19]Fontenelle, LFMendlowicz, MVMarques, CVersiani, MEarly and lateonset obsessive—compulsive disorder in adult patients: an exploratory clinical and therapeutic study. J Psychiatr Res 2003;37: 127–33.CrossRefGoogle Scholar
[20]Fontenelle, LFMendlowicz, MVVersiani, MClinical subtypes of obsessive—compulsive disorder based on the presence of checking and washing compulsions. Rev Bras Psiquiatr 2005;3:201–7.CrossRefGoogle Scholar
[21]Geter, DBiederman, JJones, JPark, KSchwartz, SShapiro, S et al. Is juvenile obsessive—compulsive disorder a developmental subtype of the disorder? A review of pediatric literature. J Am Acad Child Adolesc Psychiatry 1998;37:420–7.Google Scholar
[22]Goodman, WKPrice, LHRasmussen, SAMazare, CFleischmann, RLHill, CL et al. The Yale-Brown Obsessive Compulsive Scale I: development, use and reliability. Arch Gen Psychiatry 1989;46: 1006–11.CrossRefGoogle ScholarPubMed
[23]Gousse, VDelorme, RChabane, NPerez-Diaz, FFlavie, MMouren-Siméoni, MC et al. Is age at onset associated with executive dysfunction in obsessive—compulsive disorder? Encephale 2005 Nov—Dec;31(6 Pt 1):666–71.Google ScholarPubMed
[24]Noether Gottffried, E. Introduction to statistics: the nonparametric way. New York: Springer-Verlag; 1990. 415 p. + xii.Google Scholar
[25]Hanna, GLHilme, JACurtis, GCGillespie, BWA family study of obsessive—compulsive disorder with pediatric probands. Am J Med Genet B Neuropsychiatr Genet 2005; 134(1): 13–9.CrossRefGoogle Scholar
[26]Hemmings, SMKinnear, CJLochner, CNieLaus, DJKnowles, JAMoolman-Smook, JC et al. Early-versus late-onset obsessive—compulsive disorder: investigating genetic and clinical correlates. Psychiatry Res 2004;128:175–82.CrossRefGoogle ScholarPubMed
[27]Holzer, JCGoodman, WKMcDougle, CJBaer, LBoyarsky, BKLeckman, JF et al. Obsessive—compulsive disorder with and without a chronic tic disorder. A comparison of symptoms in 70 patients. Br J Psychiatry 1994 Apr;164(4):469–73.Google ScholarPubMed
[28]Jenike, MABaer, LMinichiello, WERauch, SLButtolph, MLPlacebocontrolled trial of fluoxetine and phenelzine for obsessive— compulsive disorder. Am J Psychiatry 1997; 154(9): 1261–4.Google Scholar
[29]Leckman, JFRiddle, MAHardin, MTOrt, SISwartz, KLStevenson, J et al. The Yale Global Tic Severity Scale: initial testing of a clinician- rated scale of tic severity. J Am Child Adolesc Psychiatry 1989;28:566–73.CrossRefGoogle ScholarPubMed
[30]Leckman, JFGrite, DEBarr, LCde Vries, ALMartin, CCohen, DJ et al. Tic-related versus non-tic-related obsessive—compulsive disorder. Anxiety 1995;1:208–15.Google Scholar
[31]Leckman, JFGrite, DEBoasdman, JZhang, HVitale, ABondi, C et al. Symptoms of obsessive—compulsive disorder. Am J Psychiatry 1997 Jul;154(7):911–7.Google ScholarPubMed
[32]Lenane, MCSwedo, SELeonard, HPauls, DLSceery, WRapoport, JLPsychiatric disorders in first degree relatives of children and adolescents with obsessive compulsive disorder. J Am Acad Child Adolesc Psychiatry 1990;29(3):407–12.CrossRefGoogle ScholarPubMed
[33]Lensi, PCassano, GBCorreddu, GRavagli, SKunovac, JLAkiskal, HSObsessive—compulsive disorder. Familial-developmental history, symptomatology, comorbidity and course with special reference to gender-related differences. Br J Psychiatry 1996 Jul;169(1):101–7.Google ScholarPubMed
[34]Leonard, HLLenane, MCSwedo, SERettew, DCGershon, ESRapoport, JLTics and Tourette's disorder: a 2 to 7 year follow-up of 54 obsessive—compulsive children. Am J Psychiatry 1992; 149(9): 1244–51.Google ScholarPubMed
[35]Luxemberg, JSSwedo, SEFlament, MFFriedland, RPRapoport, JRapoport, SINeuroanatomical abnormalities in obsessive—compulsive disorder detected with quantitative X-ray computed tomography. Am J Psychiatry 1988;145(9):1089–93.Google Scholar
[36]Marks, IMFears, phobias, and rituals. New York: Oxford University Press; 1987.Google Scholar
[37]Mataix-Cols, Ddo Rosário-Campos, MC, Leckman, JF. A multidimensional model of obsessive—compulsive disorder. Am J Psychiatry 2005;162:228–38.CrossRefGoogle ScholarPubMed
[38]Mathis, MADiniz, JBdo Rosario, MC, Torres, AR, Hoexter, M, Hasler, G. What is the optimal way to sub-divide obsessive—compulsive disorder? CNS Spectr 2006;11(10):762–8. 771-4, 776-9 [review].CrossRefGoogle Scholar
[39]Mckay, DAbramowitz, JSCalamari, JEKyrios, MRadomsky, ASookman, D et al. A critical evaluation of obsessive—compulsive disorder subtypcs: symptoms versus mechanisms. Clin Psychol Rev 2004;24:283313.CrossRefGoogle ScholarPubMed
[40]Miguel, ECRauch, SLJenike, MAObsessive—compulsive disorder. Psychiatr Clin North Am 1997;20:863–83.CrossRefGoogle ScholarPubMed
[41]Miguel, ECRosário-Campos, MRShavitt, RGHounie, AGMercadante, MTThe tic-related obsessive—compulsive disorder phenotype and treatment implications. Adv Neurol 2001;85:4355.Google ScholarPubMed
[42]Miguel, ECLeckman, JFRauch, R et al. Obsessive—compulsive disorder phenotypes: implications for genetic studies. Mol Psychiatry 2005; 10: 258–75.CrossRefGoogle ScholarPubMed
[43]Millet, BKochman, FGallarda, T et al. Phenomenological and comorbid features associated in obsessive—compulsive disorder: Influence of age of onset. J Affect Disord 2004;79:241–6.CrossRefGoogle ScholarPubMed
[44]Nestadt, GSamuels, JRiddle, M et al. A family study of obsessive— compulsive disorder. Arch Gen Psychiatry 2000;57(4):358–63.CrossRefGoogle ScholarPubMed
[45]Nestadt, GSamuels, JRiddle, MA et al. The relationship between obsessive—compulsive disorder and anxiety and affective disorders: results from the Johns Hopkins OCD Family Study. Psychol Med 2001 Apr;31(3):481–7.CrossRefGoogle ScholarPubMed
[46]Nestadt, GAddington, ASamules, J et al. The identification of OCD-related subgroups based on comorbidity. Biol Psychiatry 2003;53:914–20.CrossRefGoogle ScholarPubMed
[47]Noshirvani, HFKasvikis, YMarks, IM et al. Gender-divergent aetiological factors in obsessive—compulsive disorder. Br J Psychiatry 1991;158:260–3.CrossRefGoogle ScholarPubMed
[48]Pauls, DLAlsobrook, II JPGoodman, W et al. A family study of obsessive—compulsive disorder. Am J Psychiatric 1995; 152:7684.Google ScholarPubMed
[49]Pereira, CABStern, JMEvidence and credibility: full Bayesian significance test for precise hypotheses. Entropy J 1990;1:104–15.Google Scholar
[50]Petter, TRichter, MASandor, PClinical features distinguishing patients with Tourette's syndrome and obsessive compulsive disorder from patients with obsessive—compulsive disorder without tics. J Clin Psychiatry 1998;59(9):456–9.CrossRefGoogle ScholarPubMed
[51]Ravizza, LBarzega, GBellino, S et al. Predictors of response in obsessive—compulsive disorder. J Clin Psychiatry 1995;56:368–73.Google ScholarPubMed
[52]Rosário-Campos, MCLeckman, JFMercadante, MT et al. Adults with early-onset obsessive—compulsive disorder. Am J Psychiatry 2001; 158(11): 1899–903.CrossRefGoogle ScholarPubMed
[53]Rosário-Campos, MCLeckman, JCari, M et al. A family study of early obsessive—compulsive disorder. Am J Med Genet B Neuropsychiatr Genet 2005;136(1):92–7.CrossRefGoogle Scholar
[54]Rosenberg, DRKeshavan, MSDick, EL et al. Corpus callosal morphology in treatment-naive pediatric obsessive compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 1997;21(8): 1269–83.CrossRefGoogle ScholarPubMed
[55]Shavitt, RGBelotto, CCari, M et al. Clinical features associated with treatment response in obsessive—compulsive disorder. Compr Psychiatry 2006;47(4):276–81.CrossRefGoogle ScholarPubMed
[56]Sobin, CBlundell, MLKarayiorgou, MPhenotypic differences in earlyand late-onset obsessive—compulsive disorder. Compr Psychiatry 2000;41:373–9.CrossRefGoogle Scholar
[57]Swedo, SERapoport, JLPhenomenology and differential diagnosis of obsessive—compulsive disorder in children and adolescents. In: Rapoport, JL, editor. Obsessive—compulsive disorder in children and adolescents. Washington, DC: American Psychiatric Press; 1989. p. 1232.Google ScholarPubMed
[58]Swerdlow, RNZinner, SFarber, HR et al. Symptoms in obsessive— compulsive disorder and Tourettets syndrome: a spectrum? CNS Spectr 1999;4(3):2133.CrossRefGoogle Scholar
[59]Torres, ARPrince, MJBebbington, PE et al. Obsessive—compulsive disorder: prevalence, comorbidity, impact, and help-seeking in the British National Psychiatric Morbidity Survey of 2000. Am J Psychiatry 2006;163:1978–85.CrossRefGoogle ScholarPubMed
[60]Tukel, RPolat, AGene, A et al. Gender-related differences among Turkish patients with obsessive—compulsive disorder. Compr Psychiatry 2004;45(5):362–6.CrossRefGoogle ScholarPubMed
[61]Tukel, MDErhan, EBatmaz, S et al. Influence of age at onset on clinical features in obsessive—compulsive disorder. Depress Anxiety 2005;21:112–7.CrossRefGoogle ScholarPubMed
[62]Zonar, AHPauls, DLRatzoni, G et al. Obsessive—compulsive disorder with and without tics in an epidemiological sample of adolescents. Am J Psychiatry 1997;154(2):274–6.Google Scholar