TERAPIA COGNITIVO COMPORTAMENTAL PARA O MANEJO DAS OBSESSÕES SEXUAIS NO TRANSTORNO OBSESSIVO COMPULSIVO

UMA REVISÃO NARRATIVA

Autores

  • Fernanda Rafaela Cabral Bonato Universidade Federal do Paraná https://orcid.org/0000-0001-5408-3137
  • Bruna Gund Universidade Federal do Paraná
  • Roberta Cristina Gobbi Baccarim Universidade Tuiuti do Paraná https://orcid.org/0000-0002-3403-5979
  • Nicolas de Oliveira Cardoso Pontifícia Universidade Católica do Rio Grande do Sul

DOI:

https://doi.org/10.35919/rbsh.v35.1198

Palavras-chave:

Terapia Cognitiva Comportamental, Transtorno obsessivo compulsivo (TOC), Obsessões sexuais

Resumo

O transtorno obsessivo compulsivo (TOC) é um transtorno mental caracterizado pela presença de obsessões e compulsões. Algumas obsessões ou pensamentos intrusivos podem ter cunho sexual. O presente artigo tem por objetivo investigar as técnicas utilizadas pela Terapia Cognitivo Comportamental (TCC) para o tratamento das obsessões sexuais em pessoas com diagnóstico de TOC. Para tanto, foi realizada uma revisão narrativa por meio de consulta às bases PsycINFO, Pubmed e Socpus. Os resultados indicam que as principais técnicas da TCC utilizadas para o tratamento de obsessões sexuais são a psicoeducação, a reestruturação cognitiva, a exposição e prevenção de resposta, e as alternativas contextuais que salientam práticas de mindfulness e aceitação.

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Biografia do Autor

Fernanda Rafaela Cabral Bonato, Universidade Federal do Paraná

Mestre em Psicologia. Universidade Federal do Paraná, Departamento de Psicologia, Curitiba, Paraná. 

Bruna Gund, Universidade Federal do Paraná

Graduanda em Psicologia. Universidade Federal do Paraná, Departamento de Psicologia, Curitiba, Paraná. 

Roberta Cristina Gobbi Baccarim, Universidade Tuiuti do Paraná

Mestre em Psicologia, Departamento de Psicologia, Universidade Tuiuti do Paraná, Curitiba, Paraná. 

Nicolas de Oliveira Cardoso, Pontifícia Universidade Católica do Rio Grande do Sul

Pós Doutor em Psicologia, Departamento de Psicologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul. 

Referências

AMERICAN PSYCHIATRIC ASSOCIATION. Diagnostic and Statistical Manual of Mental Disorders. Text Revision DSM-5-TR. Arlington, VA: American Psychiatric Association, 2022.

AMERICAN PSYCHIATRIC ASSOCIATION. Practice guideline for the treatment of patients with obsessive-compulsive disorder. Arlington, VA: American Psychiatric Association, 2007.

BECK, J. S. Terapia cognitivo-comportamental: teoria e prática. 2 ed. Porto Alegre: Artmed, 2013.

BHARDWAJ, T.; SHARMA, P. Psychotherapeutic management of sexual obsessions in childhood: a case report. Indian Journal of Psychological Medicine, v. 41, n. 3, 2019. DOI: https://doi.org/10.4103/ijpsym.ijpsym_305_18

CARVALHO, M. R.; NARDI, A. E.; RANGÉ, B. Comparação entre os enfoques cognitivo, comportamental e cognitivo-comportamental no tratamento do transtorno de pânico. Revista Psiquiatria Clínica, v. 35, p. 66-73, 2007. DOI: https://doi.org/10.1590/S0101-60832008000200004

CORDIOLI, A. V. (Org.). TOC: manual de terapia cognitivo-comportamental para o Transtorno Obsessivo-compulsivo. 2 ed. Porto Alegre: Artmed, 2014.

FAIRFAX, H. Mindfulness and obsessive compulsive disorder; implications for psychological intervention. Journal of Mental Health and Clinical Psychology, v. 2, n. 4, p. 55-63, 2018. DOI: https://doi.org/10.29245/2578-2959/2018/4.1146

FILHO, J. C. V. et al. Aspectos clínicos e diagnósticos em saúde mental. Belém: Rfb Editora, 2023.

FINEBERG N. A., et al. Early intervention for obsessive compulsive disorder: an expert consensus statement. Eur Neuropsychopharmacol, v. 29, n. 4, p. 549–565, 2019. Disponível em: https://pubmed.ncbi.nlm.nih.gov/30773387/

FONTENELLE, L. F. et al. Sexual function and dysfunction in brazilian patients with obsessive-compulsive disorder and social anxiety disorder. The Journal of Nervous and Mental Disease, v. 195, n. 3, p. 254-257, 2007. DOI: https://doi.org/10.1097/01.nmd.0000243823.94086.6f

FUSS, J.; BRIKEN, P.; STEIN, D. J.; LOCHNER, C. Compulsive sexual behavior disorder in obsessive-compulsive disorder: Prevalence and associated comorbidity. Journal of Behavioral Addictions, v. 8, n. 2, p. 242-248, 2019. DOI: https://doi.org/10.1556/2006.8.2019.23

GORDON, W. M. Sexual obsessions and OCD. Sexual and Relationship Therapy, v. 17, p. 343–354, 2002. DOI: https://doi.org/10.1080/1468199021000017191

GRANT, J. E. et al. Sexual obsessions and clinical correlates in adults with obsessive-compulsive disorder. Comprehensive Psychiatry, v. 47, p. 325–329, 2006. DOI: https://doi.org/10.1016/j.comppsych.2006.01.007

HENZEL, D.; SIMPSON, H. B. Exposure and response prevention for obsessive-compulsive disorder: a review and new directions. Indian Journal of Psychiatry, v. 61, suppl 1, p. S85–S92, 2019. Doi: https://doi.org/10.4103/psychiatry.indianjpsychiatry_516_18

HEYMAN, I. et al. Prevalence of obsessive compulsive disorder in the British nationwide survey of child mental health. British Journal of Psychiatry, Londres, v. 179, p. 324-329, 2001. DOI: https://doi.org/10.4103/10.1192/bjp.179.4.324

INTERNATIONAL OCD FOUNDATION. Treatment. 2024. Disponível em: https://iocdf.org/about-ocd/treatment/#note-69-1

KARNO, M. et al. The epidemiology of obsessive compulsive disorder in five US communities. Archives of General Psychiatry, Chicago, v. 50, n. 5, p. 529-538, 1993. Doi: https://doi.org/10.1001/archpsyc.1988.01800360042006

KATZMAN, et al. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry, v. 14, suppl 1, p. S1, 2014. DOI: https://doi.org/10.1186/1471-244x-14-s1-s1

KOOLWAL, A. et al. Obsessive-compulsive disorder and sexuality: a narrative review. Journal of Psychosexual Health, v. 2, n. 1, p. 37–43, 2020. Doi: https://doi.org/10.1177/2631831819896171

KUTY-PACHECKA, M. Sexual obsessions in obsessive-compulsive disorder. Definitions, models and cognitive-behavioural therapy. Psychiatr Pol, v. 55, n. 1, p. 39-52, 2021. DOI: https://doi.org/10.12740/pp/112051

LEE, E. et al. Can distressing sexual thoughts be regulated? Experiential willingness versus distraction. Journal of Cognitive Psychotherapy, v. 32, n. 1, 2018. DOI: https://doi.org/10.1891/0889-8391.32.1.49

MANJULA, M.; SUDHIR, P. M. New-wave behavioral therapies in obsessive-compulsive disorder: moving toward integrated behavioral therapies. Indian Journal of Psychiatry, v. 61, Suppl. 7, 2019. DOI: https://doi.org/10.4103/psychiatry.indianjpsychiatry_531_18

MCKAY, D. et al. Efficacy of cognitive-behavior therapy for obsessive-compulsive disorder. Psychiatry Research, v. 227, n. 1, p. 104–113, 2015. DOI: https://doi.org/10.1016/j.psychres.2014.11.058

POZZA, A. et al. Propensity to Sexual Response among Adults with Obsessive-Compulsive Disorder. Clinical Practice & Epidemiology in Mental Health, v. 15, p. 126-133, 2019. DOI: https://doi.org/10.2174/1745017901915010126

PUCCINELLI, C. et al. Falling into the OCD trap: are clinicians hesitant to encourage exposure therapy for repugnant obsessions? Journal of Obsessive-Compulsive and Related Disorders, 2023. DOI: https://doi.org/10.1016/j.jocrd.2022.100766

REAL, E. et al. Sexuality and obsessive-compulsive disorder: the hidden affair. Neuropsychiatric, v. 3, n. 1, p. 1-9, 2013. DOI: http://dx.doi.org/10.2217/npy.12.72

REDDY, J. C. et al. Clinical practice guidelines for Obsessive-Compulsive Disorder. Indian Journal of Psychiatry, v. 59, suppl 1, p. S74–S90, 2017. DOI: https://doi.org/10.4103%2F0019-5545.196976

REID, J. E. et al. Cognitive behavioral therapy with exposure and response prevention in the treatment of obsessive-compulsive disorder: a systematic review and meta-analysis of randomized controlled trials. Comprehensive Psychiatry, v. 106, p. 152223, 2021. DOI: https://doi.org/10.1016/j.comppsych.2021.152223

ROH, D.; JANG, K. W.; KIM, C. H. Clinical Advances in Treatment Strategies for Obsessive-compulsive Disorder in Adults. Clinical Psychopharmacology and Neuroscience, v. 21, n. 4, p. 676-685, 2023. DOI: https://doi.org/10.9758/cpn.23.1075

ROTHER, E. T. Revisão sistemática X revisão narrativa. Acta Paulista de Enfermagem, v. 20, n. 2, p. v–vi, 2007. DOI: https://doi.org/10.1590/S0103-21002007000200001

SILVA, L. M. et al. Transtorno obsessivo compulsivo e suas repercussões clínicas. Brazilian Journal of Health Reviews, v. 6, n. 5, p. 23582-23591, 2023. DOI: https://doi.org/10.34119/bjhrv6n5-414

SKAPINAKIS, P. et al. A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive-compulsive disorder in children/adolescents and adults. Health Technology Assessment, v. 20, p. 1–392, 2016. DOI: https://doi.org/10.3310/hta20430

SNAYCHUK, Li. A et al. Co-Occurring Obsessive-Compulsive Disorder and Compulsive Sexual Behavior: Clinical Features and Psychiatric Comorbidities. Archives of Sexual Behavior, v. 51, n. 8, p. 4111-4123, 2022. DOI: https://doi.org/10.1007/s10508-022-02412-6

SONG, Y. et al. The effect of exposure and response prevention therapy on obsessive-compulsive disorder: A systematic review and meta-analysis. Psychiatry Research, v. 317, p. 114861, 2022. DOI: https://doi.org/10.1016/j.psychres.2022.114861

SUKHERA, Javeed. Narrative reviews: flexible, rigorous, and practical. Journal of Graduate Medical Education, v. 14, n. 4, p. 414-417, 2022. DOI: https://doi.org/10.4300/JGME-D-22-00480.1

SWIERKOSZ-LENART, K. et al. Therapies for obsessive-compulsive disorder: Current state of the art and perspectives for approaching treatment-resistant patients. Frontiers in Psychiatry, v. 14, p. 1065812, 2023. DOI: https://doi.org/10.3389/fpsyt.2023.1065812

TORRES, A. R. et al. Epidemiology, comorbidity, and burden of OCD. In: Pittenger C, editor. Obsessive-compulsive disorder: phenomenology, pathophysiology, and treatment. Oxford: Oxford University Press, 2017:35–46.

VELLA-ZARB, R. A. et al. Differentiating sexual thoughts in obsessive-compulsive disorder from paraphilias and nonparaphilic sexual disorders. Cognitive and Behavioral Practice, v. 24, n. 3, p. 342-352, 2017. DOI: https://doi.org/10.1016/j.cbpra.2016.06.007

VIVAN, A. S. Prevalência do transtorno obsessivo compulsivo e de sintomas obsessivo compulsivos e qualidade de vida em adolescentes. 2013. Tese (Doutorado em Ciências Médicas: Psiquiatria) — Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, 2013. Disponível em: http://hdl.handle.net/10183/86425

WEIDLE, B. et al. Sexual obsessions in children and adolescents: Prevalence, clinical correlates, response to cognitive-behavior therapy and long-term follow up. Journal of Obsessive-Compulsive and Related Disorders, v. 32, p. 100708, 2022. DOI: https://doi.org/10.1016/j.jocrd.2022.100708

WILLIAMS, M. T.; CROZIER, M.; POWERS, M. Treatment of sexual orientation obsessions in obsessive-compulsive disorder using exposure and ritual prevention. Clinical Case Studies, v. 10, n. 1, p. 53-66, 2011. DOI: https://doi.org/10.1177/1534650110393732

WILLIAMS, M.; FARRIS, S. G. Sexual orientation obsessions in obsessive-compulsive disorder: prevalence and correlates. Psychiatry Research, v. 187, n. 1-2, p. 156-9, 2011. DOI: https://doi.org/10.1016/j.psychres.2010.10.019

WORLD HEALTH ORGANIZATION. Defining sexual health: Report of a technical consultation on sexual health 28–31 January 2002. Geneva: World Health Organization, 2006.

WORLD HEALTH ORGANIZATION. ICD-11 Reference Guide. 2019. Disponível em: https://icdcdn.who.int/icd11referenceguide/en/html/index.html

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Publicado

2024-12-16

Como Citar

Bonato, F. R. C., Gund, B., Baccarim, R. C. G., & Cardoso, N. de O. (2024). TERAPIA COGNITIVO COMPORTAMENTAL PARA O MANEJO DAS OBSESSÕES SEXUAIS NO TRANSTORNO OBSESSIVO COMPULSIVO: UMA REVISÃO NARRATIVA . Revista Brasileira De Sexualidade Humana, 35, 1198 . https://doi.org/10.35919/rbsh.v35.1198

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Opinativos e de Revisão