Resumen
Definición
病史和体格检查
关键诊断因素
- presença de fatores de risco
- obsessões
- compulsões
- fenômenos sensoriais
- transtorno de personalidade esquizotípica
- transtorno de tique
- coordenação motora reduzida
- dificuldades sensório-perceptivas
- dificuldades no sequenciamento de tarefas motoras complexas
其他诊断因素
- sexo masculino
危险因素
- história familiar de transtorno obsessivo-compulsivo (TOC)
- PANDAS/PANS (transtornos neuropsiquiátricos pediátricos autoimunes associados a infecções estreptocócicas/síndrome neuropsiquiátrica pediátrica de início agudo)
- gestação
- sexo masculino (início mais cedo, evolução mais crônica e resistência ao tratamento)
- maior frequência das compulsões (resistência ao tratamento)
- idade precoce de início (resistência ao tratamento)
- hospitalizações anteriores por transtorno obsessivo-compulsivo (TOC [resistência ao tratamento])
- transtorno de personalidade esquizotípica (resistência ao tratamento)
- transtorno de tique (resistência ao tratamento)
- anormalidades estruturais do cérebro específicas ou difusas (resistência ao tratamento)
诊断性检查
首要检查
- nenhum exame inicial
需考虑的检查
- Entrevista Clínica Estruturada do DSM (SCID)
- Escala de Sintomas Obsessivo-Compulsivos de Yale-Brown (Y-BOCS)
- Impressão clínica global (CGI)
治疗流程
sintomas leves a moderados: sem transtornos de personalidade comórbidos ou sintomas dissociativos
sintomas graves ou com transtornos de personalidade comórbidos ou sintomas dissociativos
撰稿人
作者
Phillip J. Seibell, MD, FAPA

OCD and Anxiety Psychiatry of Westchester, P.C.
Hawthorne
NY
Disclosures
PJS declares that he has no competing interests.
Stefano Pallanti, MD, PhD

Professor of Psychiatry
Institute of Neuroscience
Florence
Italy
Disclosures
SP declares that he has no competing interests. SP is an author of several references cited in this topic.
Silvia Bernardi, MD

Project Manager
New York State Psychiatric Institute
Columbia University
New York
NY
Disclosures
SB receives research sponsorship from NYSPI, APA, and the Brain & Behavior Research Foundation. SB is also a board member of the New York council on Problem Gambling. SB is an author of a reference cited in this topic.
Megan Hughes-Feltenberger, PhD

Clinical Assistant Professor of Psychology in Psychiatry
Weill Cornell Medicine
New York
NY
Disclosures
MHF declares that she has no competing interests.
Eric Hollander, MD

Clinical Professor of Psychiatry and Behavioral Sciences
Director
Compulsive, Impulsive and Autism Spectrum Disorder Program
Albert Einstein College of Medicine
Montefiore Medical Center
New York
NY
Disclosures
EH has received research grants from Jazz, Roche, and Compass.
Acknowledgements
The authors would like to gratefully acknowledge Dr Ashley Braun, a previous contributor to this topic. AB declares that she has no competing interests.
Peer reviewers
Darin D. Dougherty, MD
Director
Division of Neurotherapeutics
Massachusetts General Hospital
Boston
MA
Disclosures
DDD has received research funding and honoraria from Medtronic. DDD has served as an advisor and received honoraria from Sage, Celenase, and Boehringer-Ingelheim. DDD has served as an advisor and received equity from Neurable, Innercosmos, and Intrinsic Powers.
Robert Hudak, MD
Associate Professor of Psychiatry
University of Pittsburgh School of Medicine
Pittsburgh
Pennsylvania
PA
Disclosures
RH declares that he has no competing interests.
Juliana Belo Diniz, MD
Psychiatrist
Department and Institute of Psychiatry
Clinical Hospital
University of Sao Paulo Medical School
Sao Paulo
Brazil
Disclosures
JBD declares that she has no competing interests.
Amit Nigam, MBBS, MRCPsych
Specialist Registrar in Forensic Psychiatry and Honorary Research Worker
National OCD Service
Queen Elizabeth II Hospital
Welwyn Garden City
Forensic Psychiatrist
West London Mental Health NHS Trust
London
UK
Disclosures
AN declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
World Health Organization. International statistical classification of diseases and related health problems. 11th revision. Jan 2022 [internet publication].Full text
American Psychiatric Association. Practice guideline for the treatment of patients with obsessive-compulsive disorder. Jul 2007 [internet publication].Full text
American Psychiatric Association. Guideline watch (March 2013): practice guideline for the treatment of patients with obsessive-compulsive disorder. Mar 2013 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Transtorno de personalidade obsessivo-compulsivo (TPOC)
- Transtorno dismórfico corporal (TDC)
- Transtorno de sintomas somáticos
More DifferentialsGuidelines
- Guidelines for the pharmacological treatment of anxiety disorders, obsessive-compulsive disorder and posttraumatic stress disorder in primary care
- Diagnostic and statistical manual of mental disorders, fifth edition, text revision (DSM-5-TR)
More GuidelinesPatient information
Transtorno obsessivo-compulsivo
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