¿Sabes qué es el trastorno obsesivo compulsivo (TOC)?
Definición de trastorno obsesivo compulsivo
El trastorno obsesivo compulsivo (TOC) se caracteriza por la presencia de obsesiones y/o compulsiones. Las obsesiones son pensamientos, impulsos o imágenes recurrentes y persistentes que se experimentan como intrusivos y no deseados. La persona intenta ignorar o suprimir estas obsesiones o neutralizarlas con algún otro pensamiento o acto, es decir, realizando una compulsión.
Las compulsiones son conductas repetitivas o actos mentales que un individuo se siente impulsado a realizar en respuesta a una obsesión o de acuerdo con reglas que deben aplicarse rígidamente. Por ejemplo: lavarse las manos, ordenar, comprobar cosas, contar, repetir palabras en silencio. El objetivo de los comportamientos o actos mentales es prevenir o disminuir la ansiedad o el malestar, o evitar algún suceso o situación temida.
Mientras que el contenido específico de las obsesiones y las compulsiones varía entre los individuos, ciertas dimensiones de los síntomas del TOC son comunes, como los síntomas de limpieza, la simetría y repetición, los pensamientos tabú o prohibidos y de daño.
Características del trastorno obsesivo compulsivo
Las obsesiones o compulsiones requieren mucho tiempo (más de una hora al día) o causan malestar clínicamente significativo o deterioro en lo social, laboral u otras áreas importantes de funcionamiento.
La edad media de inicio del TOC es de 19,5 años, y el 25% de los casos se inicia a la edad de 14 años. Su comienzo después de los 35 años es inusual, pero ocurre. Los varones tienen una edad más temprana de inicio de los síntomas que las mujeres; casi el 25% de los varones tienen un inicio antes de la edad de 10 años. El inicio de la sintomatología suele ser gradual, sin embargo, también se ha descrito la aparición aguda. El patrón de los síntomas en los adultos suele ser más estable en el tiempo, pero es más variable en los niños.
Causas del TOC
Factores ambientales: El maltrato físico y sexual en la infancia y otros sucesos estresantes o traumáticos se han asociado con un mayor riesgo de desarrollar TOC.
Factores genéticos: La tasa de TOC en los familiares de primer grado de los adultos con TOC es aproximadamente dos veces mayor que entre los familiares de primer grado de los que no tienen el trastorno.
Consecuencias del TOC
El TOC está asociado con una menor calidad de vida, así como altos niveles de deterioro en la vida social y laboral. Los pensamientos suicidas se producen en aproximadamente la mitad de los individuos con TOC en algún momento de sus vidas. También pueden producirse consecuencias en la salud. Por ejemplo, los individuos con problemas de contaminación pueden desarrollar problemas dermatológicos debido al exceso de lavado. Cuando el trastorno comienza en la niñez o en la adolescencia, las personas pueden experimentar dificultades en el desarrollo, como evitar la socialización con los compañeros, falta de autonomía o dificultad para vivir de forma independiente fuera de su familia de origen.
Tratamiento del TOC
Los psicoterapeutas de orientación psicodinámica sostienen que los factores más importantes determinantes de los trastornos de ansiedad son los eventos intrapsíquicos y las motivaciones inconscientes. Afirman que al comprender las raíces inconscientemente de la ansiedad, la persona puede dirigir su actividad a modificar o abandonar la conducta no deseada.
La perspectiva conductual en lugar de hablar de síntomas causados por eventos subyacentes, centra su atención en las respuestas adquiridas y las tendencias de respuesta. Los conceptos de aprendizaje, como condicionamiento, reforzamiento y extinción, han sido aplicados cada vez con más frecuencia al estudio de los trastornos de ansiedad.
La perspectiva cognitiva destaca la manera en la que ciertos pensamientos y estilos de pensar producen efectos no deseados en la conducta. De acuerdo con los teóricos cognitivos, las alteraciones del pensamiento que ocurren sólo en ciertos lugares o en relación con problemas específicos son la fuentes de la ansiedad.
Una de las técnicas que emplean dichos terapeutas es la reestructuración cognitiva que consiste en ayudar a los clientes a revisar sus creencias y expectativas irracionales y a desarrollar formas más racionales de ver su vida.
La detención de pensamiento, el ensayo cognitivo son otras técnicas cognitivas que se utilizan para eliminar los pensamientos obsesivos cuando éstos se presentan. La terapia con fármacos ha mostrado su eficacia para tratar los trastornos de angustia y los obsesivos- compulsivos.
El trastorno obsesivo compulsivo es estudiado en uno de nuestros módulos del posgrado en Psiquiatría de 4Doctors Medical School. Si te gustaría formarte en esta área de la mano de un profesorado reconocido e Internacional no dudes en contactarnos. Más información pulsando aquí.
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