Publication: Trastorno obsesivo-compulsivo durante el período perinatal: epidemiología, fenomenología, etiopatogenia y tratamiento
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Date
2015-01
Authors
Frías, Álvaro ; Palma, Carolina ; Barón, Francisco ; Varela, Paloma ; Álvarez, Ana ; Salvador, Ana
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Publisher
Murcia: Universidad de Murcia, Editum
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DOI
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info:eu-repo/semantics/article
Description
Abstract
El objetivo de la presente revisión teórica es describir los principales hallazgos e investigaciones sobre el trastorno obsesivo-compulsivo (TOC) durante el período perinatal. Por una parte, los estudios epidemiológicos señalan que en esta etapa aumenta el riesgo de debut y/o exacerbación del TOC, especialmente en el puerperio. A nivel fenomenológico, predominan las obsesiones agresivas y de contaminación relacionadas con la figura del feto o neonato. En cuanto a su etiopatogenia, existen evidencias indirectas para postular la participación de variables neuroendocrinas (p.e. esteroides gonadales femeninos y oxitocina) y cognitivo-conductuales (p.e. hiperresponsabilidad, sobreestimación de la amenaza y control mental), siendo necesaria una mayor contrastación empírica de estos correlatos y/o factores de vulnerabilidad específicos. En el ámbito interventivo, se carece de ensayos clínicos aleatorizados con grupo control adaptados a las características idiosincrásicas de este subgrupo de sujetos con TOC. Así mismo, se destaca el papel de la terapia cognitivo-conductual (TCC) en el marco de la prevención primaria selectiva.
The aim of this review is to describe the main theoretical findings and research conclusions about obsessive-compulsive disorder (OCD) in the perinatal period. On one hand, epidemiological studies show that the risk of OCD onset and/or exacerbation could increase in this period, particularly in the puerperium. Phenomenologically, in this stage aggressive and contamination obsessions are very common and are related to the fetus or newborn. On the other hand, regarding OCD pathogenesis in this period, there is indirect evidence to suggest the participation of neuroendocrine (e.g. female gonadal steroids and oxytocin) and cognitive behavioural variables (e.g. hyper-responsibility, threat overestimation, and mental control). In terms of research, more empirical studies are needed to contrast these specific vulnerability factors. Moreover, no empirically validated psychotherapeutic treatments (controlled trials) adapted to this OCD subgroup were found, although some studies highlight the role of cognitive behavioural therapy (CBT) as an effective intervention in the context of selective primary prevention.
The aim of this review is to describe the main theoretical findings and research conclusions about obsessive-compulsive disorder (OCD) in the perinatal period. On one hand, epidemiological studies show that the risk of OCD onset and/or exacerbation could increase in this period, particularly in the puerperium. Phenomenologically, in this stage aggressive and contamination obsessions are very common and are related to the fetus or newborn. On the other hand, regarding OCD pathogenesis in this period, there is indirect evidence to suggest the participation of neuroendocrine (e.g. female gonadal steroids and oxytocin) and cognitive behavioural variables (e.g. hyper-responsibility, threat overestimation, and mental control). In terms of research, more empirical studies are needed to contrast these specific vulnerability factors. Moreover, no empirically validated psychotherapeutic treatments (controlled trials) adapted to this OCD subgroup were found, although some studies highlight the role of cognitive behavioural therapy (CBT) as an effective intervention in the context of selective primary prevention.
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