Publication: Alteraciones neuropsicológicas en el trastorno obsesivo compulsivo refractario al tratamiento
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2022-10-14
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Universidad Complutense de Madrid
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Abstract
El trastorno obsesivo compulsivo es uno de los trastornos mentales más incapacitantes y crónicos, que afecta aproximadamente al 2,5% de la población. Se caracteriza por la presencia de obsesiones, pensamientos repetitivos, intrusivos y persistentes; normalmente acompañadas de comportamientos compulsivos, rígidos, ritualísticos y repetitivos, que disminuyen la ansiedad o el malestar causado por los pensamientos obsesivos. Hasta el 40-60% de los pacientes con este trastorno, no responde al tratamiento. Más aún, el 10% de los pacientes con trastorno obsesivo compulsivo, son considerados pacientes refractarios al tratamiento, ya que no responden al tratamiento farmacológico de primera línea ni a los tratamientos psicoterapéuticos. En este subgrupo con frecuencia se consideran otros tipos de terapias más invasivas, como la estimulación cerebral profunda o la psicocirugía. En las últimas décadas, ha surgido un creciente interés en el estudio de las funciones cognitivas de estos pacientes, emergiendo modelos neurobiológicos para este trastorno. Los pacientes con trastorno obsesivo compulsivo presentan una serie de déficits a nivel cognitivo en diferentes procesos, especialmente en funciones ejecutivas y en velocidad de procesamiento de la información. Algunos estudios han sugerido que los déficits en velocidad de procesamiento puedan subyacer al pobre rendimiento cognitivo en otros procesos, pero esta hipótesis no se ha explorado, ni en población general de pacientes con trastorno obsesivo compulsivo ni en el subgrupo refractario al tratamiento. Además, si estas alteraciones cognitivas están o no relacionadas con la gravedad de la sintomatología, o constituyen un déficit primario, es otro aspecto que permanece aún sin resolver en este subgrupo...
Obsessive compulsive disorder is one of the most disabling and chronic disorders, and it affects approximately 2,5% of the general population. It is characterized by repetitive, persistent and unwanted thoughts, and compulsive, ritualized, rigid and repetitive behaviors, that reduce the anxiety provoked by the obsessions. Approximately 40-60% of the patients affected by this disorder, do not respond to pharmacological and behavioral treatment. Moreover, up to 10% of the patients with obsessive compulsive disorder are considered refractory to treatment, because they do not respond to first line established treatments, either pharmacological or psychotherapeutic. Other more invasive techniques are normally considered for this subgroup, like deep brain stimulation or psychosurgery.In the last decades, a growing body of literature about the cognitive functioning of these patients, and neurobiological models, has emerged. Cognitive deficits in executive functions and speed of information processing are reported in patients with obsessive-compulsive disorder. Some studies have even suggested that speed deficits may underlie poor neuropsychological performance. In other cognitive domains, however, this hypothesis remains unanswered in both the general obsessive compulsive disorder population and the refractory subgroup. In addition, it is not clear whether such deficits are secondary to the clinical symptoms or may constitute a primary deficit...
Obsessive compulsive disorder is one of the most disabling and chronic disorders, and it affects approximately 2,5% of the general population. It is characterized by repetitive, persistent and unwanted thoughts, and compulsive, ritualized, rigid and repetitive behaviors, that reduce the anxiety provoked by the obsessions. Approximately 40-60% of the patients affected by this disorder, do not respond to pharmacological and behavioral treatment. Moreover, up to 10% of the patients with obsessive compulsive disorder are considered refractory to treatment, because they do not respond to first line established treatments, either pharmacological or psychotherapeutic. Other more invasive techniques are normally considered for this subgroup, like deep brain stimulation or psychosurgery.In the last decades, a growing body of literature about the cognitive functioning of these patients, and neurobiological models, has emerged. Cognitive deficits in executive functions and speed of information processing are reported in patients with obsessive-compulsive disorder. Some studies have even suggested that speed deficits may underlie poor neuropsychological performance. In other cognitive domains, however, this hypothesis remains unanswered in both the general obsessive compulsive disorder population and the refractory subgroup. In addition, it is not clear whether such deficits are secondary to the clinical symptoms or may constitute a primary deficit...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Psicología, Departamento de Psicología Básica II (Procesos Cognitivos), leída el 10-05-2022