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Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging
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Del tratamiento quirúrgico al progreso psiquiátrico en el trastorno obsesivo-compulsivo refractario: un informe de
Shotaro Fujiwara1, Yasushi Okamura1, Hitomi Wake2
1Department of Psychiatry Tokyo Metropolitan Matsuzawa Hospital Tokyo Japan.
PCN reports : psychiatry and clinical neurosciences
|September 5, 2025
Resumen
El tratamiento de las complicaciones físicas del trastorno obsesivo-compulsivo (TOC) puede mejorar los síntomas psiquiátricos. La intervención quirúrgica para el prolapso rectal en un paciente con TOC grave redujo inesperadamente los comportamientos compulsivos y facilitó la participación en el tratamiento psiquiátrico.
Área de la Ciencia:
- La neurociencia
- Gastroenterología
- La psiquiatría
Sus antecedentes:
- El trastorno obsesivo-compulsivo (TOC) puede manifestarse con complicaciones físicas graves.
- La interacción entre los síntomas físicos y los resultados del tratamiento psiquiátrico en el TOC sigue siendo incompletamente entendida.
- Este caso explora la relación bidireccional entre la morbilidad física grave relacionada con el TOC y la atención psiquiátrica.
Objetivo del estudio:
- Investigar el impacto de la resolución de una complicación física en los síntomas psiquiátricos en el TOC resistente al tratamiento.
- Examinar si la intervención física puede servir como catalizador para la participación en el tratamiento psiquiátrico.
- Para resaltar la importancia de la atención integrada en casos complejos de TOC.
Principales métodos:
- Informe de caso de una mujer de unos 50 años con TOC grave, de larga data, resistente al tratamiento.
- Centrarse en el temor a la contaminación y los rituales de defecación compulsiva que conducen al prolapso rectal y la incontinencia fecal.
- Intervención quirúrgica (rectopexia laparoscópica) para tratar la incontinencia fecal.
Principales resultados:
- Resolución cirúrgica exitosa de la incontinencia fecal.
- Reducción significativa en los comportamientos compulsivos de limpieza relacionados con el TOC y el tiempo dedicado a los rituales.
- Mejor participación psiquiátrica, lo que lleva a visitas ambulatorias regulares y progreso terapéutico.
- Demostración de un ciclo vicioso roto entre los síntomas físicos y psiquiátricos.
Conclusiones:
- La intervención física puede aliviar la angustia somática y actuar como un catalizador para la atención psiquiátrica en el TOC.
- Abordar las complicaciones físicas puede crear una apertura para establecer confianza y motivación en los pacientes.
- La colaboración integrada e interdisciplinaria es crucial para el manejo del TOC complejo con síntomas somáticos y psiquiátricos entrelazados.
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