Sindrome di Tourette: alla faccia della PANDAS!

2020 ◽  
Vol 23 (9) ◽  
pp. 225-227
Author(s):  
Dante Ferrara
Keyword(s):  
Clinical Case ◽  
Behavioural Therapy ◽  
Good Prognosis ◽  
Partial Regression ◽  
Good Clinical Response ◽  
Obsessive Compulsive ◽  
Cognitive Behavioural ◽  
Obsessive Compulsive Disorders ◽  
Compulsive Disorders

The paper describes the clinical case of a ten-year-old boy with Tourette’s syndrome, initially classified as PANDAS. The persistence, the complexity of the symptoms and the comorbidity with obsessive-compulsive disorders (OCD) have framed the case as Tourette syndrome and OCD. Treatment with cognitive behavioural therapy and aripiprazole gave a good clinical response, with partial regression of the symptoms. In the light of clinical improvement, a good prognosis is expected in the long term.

Body Dysmorphic Disorder: A Review of the Current Knowledge

2000 ◽  
Vol 5 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Esther Sobanski ◽  
Martin H. Schmidt
Keyword(s):  
Body Dysmorphic Disorder ◽  
Current Knowledge ◽  
Behavioural Therapy ◽  
Obsessive Compulsive ◽  
Psychotherapeutic Treatment ◽  
Cognitive Behavioural ◽  
Obsessive Compulsive Disorders ◽  
Relationship Of ◽  
The Relationship ◽  
Compulsive Disorders

Body Dysmorphic Disorder (BDD) is an excessive preoccupation with an imagined, or real, slight defect in normal physical appearance. The disorder, which usually begins during adolescence, tends to be chronic, and probably is much more common than is usually thought. This review presents an overview of the available scientific literature of BDD. It provides information about historical aspects, epidemiology, clinical features, aetiology, and instruments for assessing BDD. The relationship of BDD with other psychiatric disorders such as depression, obsessive-compulsive disorders, anxiety disorders, schizophrenia, eating disorders and personality disorders is discussed. Aetiological theories, including psychological and neurobiological explanations, are reviewed. Finally, psychopharmacological and psychotherapeutic treatment approaches are presented with special regard to treatment with serotonin-reuptake inhibitors, behavioural therapy and cognitive-behavioural therapy.

Response-Disequilibrium Therapy: Clinical Case Studies

2019 ◽  
Vol 7 (5) ◽  
pp. 982-999 ◽  
Author(s):  
Richard M. McFall ◽  
James Allison ◽  
Richard J. Viken ◽  
William Timberlake
Keyword(s):  
Case Studies ◽  
Clinical Case ◽  
Clinical Intervention ◽  
Behavioral Changes ◽  
Obsessive Compulsive ◽  
Clinical Case Studies ◽  
Baseline Levels ◽  
Obsessive Compulsive Disorders ◽  
Compulsive Disorders ◽  
Basic Learning

Basic learning theorists developed the response-disequilibrium model to resolve the long-standing psychological puzzle of how to specify in advance the circumstances that will yield reinforcement effects. The model explains the behavioral changes in reinforcement effects as predictable adaptations to external constraints on the free-baseline levels of those behaviors. Here we introduce response-disequilibrium therapy (RDx), a clinical intervention based on this model. We present a series of clinical case studies using RDx to treat obsessive-compulsive disorders, report highly favorable results in comparison with the standard therapy, and discuss the implications.

Why ritualized behavior? Precaution Systems and action parsing in developmental, pathological and cultural rituals

2006 ◽  
Vol 29 (6) ◽  
pp. 595-613 ◽  
Author(s):  
Pascal Boyer ◽  
Pierre Liénard
Keyword(s):  
Obsessive Compulsive ◽  
Apparent Lack ◽  
Everyday Practices ◽  
Combining Evidence ◽  
Normal Input ◽  
Obsessive Compulsive Disorders ◽  
Compulsive Disorders ◽  
Proper Performance ◽  
Normal Adults

Ritualized behavior, intuitively recognizable by its stereotypy, rigidity, repetition, and apparent lack of rational motivation, is found in a variety of life conditions, customs, and everyday practices: in cultural rituals, whether religious or non-religious; in many children's complicated routines; in the pathology of obsessive-compulsive disorders (OCD); in normal adults around certain stages of the life-cycle, birthing in particular. Combining evidence from evolutionary anthropology, neuropsychology and neuroimaging, we propose an explanation of ritualized behavior in terms of an evolved Precaution System geared to the detection of and reaction to inferred threats to fitness. This system, distinct from fear-systems geared to respond to manifest danger, includes a repertoire of clues for potential danger as well as a repertoire of species-typical precautions. In OCD pathology, this system does not supply a negative feedback to the appraisal of potential threats, resulting in doubts about the proper performance of precautions, and repetition of action. Also, anxiety levels focus the attention on low-level gestural units of behavior rather than on the goal-related higher-level units normally used in parsing the action-flow. Normally automatized actions are submitted to cognitive control. This “swamps” working memory, an effect of which is a temporary relief from intrusions but also their long-term strengthening. Normal activation of this Precaution System explains intrusions and ritual behaviors in normal adults. Gradual calibration of the system occurs through childhood rituals. Cultural mimicry of this system's normal input makes cultural rituals attention-grabbing and compelling. A number of empirical predictions follow from this synthetic model.

scholarly journals Basic mechanisms of, and treatment planning/targets for, obsessive–compulsive disorder

2020 ◽  
pp. 976-986
Author(s):  
Eric Burguière ◽  
Luc Mallet
Keyword(s):  
Neural Networks ◽  
Behavioural Therapy ◽  
Therapeutic Approaches ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Number Of Patients ◽  
The Neural Networks ◽  
Novel Approaches ◽  
Obsessive Compulsive Disorders ◽  
Compulsive Disorders

Despite the range of conventional treatments available for obsessive–compulsive disorders, generally based on pharmacological and behavioural therapy, a significant number of patients receive no benefit from them. Clearly, further work is required to develop alternative therapeutic approaches to improve the treatment of the dysfunctional cognitive processes in obsessive–compulsive disorders and to better understand the neural networks involved. Some innovative tools have recently been developed in the fields of anatomical and functional imaging, neuromodulation, and animal models. These novel approaches offer opportunities to improve our understanding of the functional and pathophysiological basis of obsessive–compulsive disorders.

Contemporary psychosurgery: indications, outcome and the Irish experience

1998 ◽  
Vol 15 (4) ◽  
pp. 119-123 ◽  
Author(s):  
Miriam O'Doherty ◽  
Paul K Bridges
Keyword(s):  
Adverse Effects ◽  
Affective Disorders ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
National Unit ◽  
Low Incidence ◽  
Obsessive Compulsive Disorders ◽  
Compulsive Disorders ◽  
Long Term Adverse Effects

AbstractObjectives: To review recent use of psychosurgery in Britain and Ireland; to outline the indications and contraindications; and to summarise the Irish experience of psychosurgery.Method: The Geoffrey Knight National Unit for Affective Disorders (GKU), now based at the Maudsley Hospital has performed the largest number of psychosurgical operations in the last 30 years. This paper reviews criteria for referral and outcome of stereotactic subcaudate tractotomy at the GKU. The twenty-one referrals from Ireland to the Unit, resulting in eight operations over the fifteen year period 1981-1995, are considered separately.Results: The efficacy of stereotactic subcaudate tractotomy is of the order of 30-60% and there is a low incidence of long-term adverse effects. The outcome of the eight Irish patients who underwent psychosurgery compare favourably with the overall outcome figures for the Unit.Conclusions: Stereotactic subcaudate tractotomy remains a treatment of last resort in the rare cases of severely treatment-resistant affective disorders and obsessive compulsive disorders.

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