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    ABSTRACT: O trabalho descreve um paciente com transtorno dismórfico corporal que respondeu preferencialmente com venlafaxina. Além disso, revisa a literatura sobre o assunto e discute similaridades e diferenças com o distúrbio obsessivo-compulsivo. Dismorfofobia corporal. Transtorno obsessivo-compulsivo. Antidepressivos. A body dysmorphic disorder (BDD) patient who responded preferentially to venlafaxine is described. A litera- ture review was carried out, and the paper also discusses the similarities and differences between BDD and obsessive-compulsive disorder. Body dysmorphic disorder. Obsessive-compulsive disorder. Antidepressive agents.
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    ABSTRACT: RESUMEN: El Espectro Obsesivo-Compulsivo, concepto surgido en la década de los noventa1, agrupa una serie amplia de trastornos, hipotéticamente relacionados con el Trastorno Obsesivo-Compulsivo (TOC) a nivel clínico, demográfico, de historia familiar, curso evolutivo y respuesta terapeútica. Dependiendo de los autores considerados2, el Espectro incluye trastornos relacionados con experiencias corporales -como el trastorno dismórfico corporal o la hipocondría-, trastornos del control de los impulsos -como tricotilomanía, cleptomanía, compra compulsiva o juego patológico-, trastornos de la conducta alimentaria, trastorno por tics e incluso algunas conductas adictivas, las parafilias o los trastornos de personalidad impulsivos como el Trastorno Límite o Antisocial. Se ha postulado que este grupo de patologías comparte unas manifestaciones clínicas comunes, como la presencia de pensamientos reiterativos y la dificultad para inhibir o retrasar comportamientos repetitivos. Estos síntomas se enmarcarían en una dimensión compulsividad-impulsividad, con sobreestimación del daño y evitación del mismo en el polo compulsivo, e infravaloración del daño y búsqueda de sensaciones en el extremo impulsivo3. Otros aspectos que apoyarían la agrupación de estos trastornos serían la elevada comorbilidad e historia familiar de TOC en algunos de ellos -especialmente el trastorno por tics múltiples-, la cronicidad de los mismos y especialmente la pretendida respuesta terapeútica específica a un grupo común de fármacos: los inhibidores de la recaptación de serotonina4. Este ponencia aborda este último aspecto, analizando la respuesta al abordaje farmacológico de estas patologías.
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    ABSTRACT: Body dysmorphic disorder (BDD) is defined as a preoccupation with an imagined or minimal defect in appearance. Virtually any body part can be the focus of concern, although preoccupations with the hair, nose and skin are particularly common. Associated features include repetitive and often ritualistic behaviours, such as mirror checking and requests for reassurance, as well as ideas or delusions of reference. The degree of impairment associated with the disorder is variable, but most patients experience significant functional impairment as a result of their concerns. While this often secret disorder has been described for more than a century and reported around the world, it has received little empirical investigation. Nonetheless, emerging data suggest that BDD is frequently a chronic disorder that usually begins during adolescence. Psychiatric hospitalisation and suicide attempts are common in patients with BDD. Disorders that are frequently comorbid include major depression, social phobia and obsessive-compulsive disorder. The prevalence of BDD among patients with other psychiatric disorders, such as atypical depression, obsessive-compulsive disorder and social phobia, appears to be relatively high. The majority of patients with BDD seek often costly nonpsychiatric therapies, such as surgical or dermatological interventions. These approaches are usually unsuccessful. In contrast, preliminary data from noncomparative studies suggest that serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors are often, and perhaps preferentially, effective in the treatment of BDD. Other preliminary data suggest that cognitive-behavioural strategies may also be useful. There are virtually no data on treatment-resistant BDD, but certain pharmacological approaches including augmentation, combination and switching strategies are sometimes effective. Further investigation of all aspects of this understudied disorder is greatly needed. Aspects that require particular attention are the epidemiology, clinical features, relationship to other psychiatric disorders, biology and, ultimately, aetiology and treatment response.
    CNS Drugs 01/1995; 3(1). DOI:10.2165/00023210-199503010-00004 · 4.38 Impact Factor
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