Obsessive-compulsive disorder in the perinatal period: Epidemiology, phenomenology, pathogenesis, and treatment. [Trastorno obsesivo-compulsivo durante el período perinatal: epidemiología, fenomenología, etiopatogenia y tratamiento]
Resumen
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.Descargas
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