Uso de la terapia cognitivo-conductual en el tratamiento de trastornos obsesivo-compulsivos
DOI:
https://doi.org/10.56183/iberojhr.v5i2.831Palavras-chave:
Trastornos obsesivo-compulsivos, Terapia cognitivo-conductual, Tratamiento, Salud mental, Técnicas terapéuticas, Psicoterapia.Resumo
La terapia cognitivo-conductual (TCC) ha demostrado ser una intervención eficaz en el tratamiento de los trastornos obsesivo-compulsivos (TOC), posicionándose como el enfoque terapéutico de primera línea. Este artículo de revisión narrativa explora los fundamentos teóricos, las técnicas principales y la evidencia empírica que respalda su uso en pacientes con TOC. La TCC combina estrategias cognitivas, como la reestructuración de pensamientos disfuncionales, con técnicas conductuales, destacando la exposición con prevención de respuesta (EPR) como su componente central. La EPR busca reducir la ansiedad asociada a las obsesiones mediante la exposición gradual y controlada, evitando las compulsiones que perpetúan el ciclo del trastorno. Además, se analizan adaptaciones para casos complejos y comorbilidades, así como las limitaciones y desafíos en su implementación. Los estudios revisados indican tasas significativas de mejora en los síntomas y la calidad de vida de los pacientes, consolidando a la TCC como una herramienta clave en el abordaje del TOC. Sin embargo, persiste la necesidad de investigaciones que profundicen en su eficacia a largo plazo y en poblaciones diversas. Este análisis proporciona una visión integral para profesionales interesados en optimizar el tratamiento de este trastorno.
Referências
Abramowitz, J. S., McKay, D., & Storch, E. A. (2017). Theoretical foundations of cognitive-behavioral therapy for obsessive-compulsive disorder. Clinical Psychology Review, 54, 1-14. https://doi.org/10.1016/j.cpr.2017.03.001
Franklin, M. E., & Foa, E. B. (2020). Cognitive-behavioral therapy for obsessive-compulsive disorder: Progress and challenges. Depression and Anxiety, 37(8), 646-657. https://doi.org/10.1002/da.23028
Hezel, D. M., & Simpson, H. B. (2019). Exposure and response prevention for obsessive-compulsive disorder: A review and new directions. Indian Journal of Psychiatry, 61 (Suppl 1), S85-S92. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_523_18
Kalanthroff, E., Anholt, G., & Simpson, H. B. (2018). Clinical advances in obsessive-compulsive disorder: A focus on mechanisms and treatment strategies. Current Psychiatry Reports, 20 (12), 102. https://doi.org/10.1007/s11920-018-0972-y
McGuire, J. F., Piacentini, J., Lewin, A. B., et al. (2015). A meta-analysis of cognitive behavior therapy and medication for child obsessive-compulsive disorder: Moderators of treatment efficacy, response, and remission. Depression and Anxiety, 32(8), 580-593. https://doi.org/10.1002/da.22389
Olatunji, B. O., Davis, M. L., Powers, M. B., & Smits, J. A. J. (2013). Cognitive-behavioral therapy for obsessive-compulsive disorder: A meta-analysis of treatment outcome and moderators. Journal of Psychiatric Research, 47(1), 33-41. https://doi.org/10.1016/j.jpsychires.2012.08.020
Rees, C. S., & Anderson, R. A. (2013). A review of group-based cognitive-behavioral therapy for obsessive-compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 2(4), 393-403. https://doi.org/10.1016/j.jocrd.2013.07.003
Simpson, H. B., & Wetterneck, C. T. (2022). Advances in cognitive-behavioral therapy for obsessive-compulsive disorder: Mechanisms and applications in diverse populations. Current Psychiatry Reports, 24(5), 215-223. https://doi.org/10.1007/s11920-022-01300-2
Storch, E. A., Lehmkuhl, H., Ricketts, E., et al. (2016). Predictors of functional impairment in youth with obsessive-compulsive disorder: The roles of cognitive-behavioral therapy and family accommodation. Journal of Anxiety Disorders, 42, 65-71. https://doi.org/10.1016/j.janxdis.2016.06.003
Taylor, S., Abramowitz, J., & McKay, D. (2020). Cognitive-behavioral models of obsessive-compulsive disorder: Evolution and refinement over four decades. Clinical Psychology Review, 81, 101892. https://doi.org/10.1016/j.cpr.2020.101892
Tolin, D., Abramowitz, J., & Diefenbach, G. (2015). Defining response in cognitive-behavioral therapy for obsessive-compulsive disorder: A meta-analytic review of criteria used in randomized controlled trials. Journal of Anxiety Disorders, 30, 8-17. https://doi.org/10.1016/j.janxdis.2014.12.002
Turner, C., Mataix-Cols, D., Lovell, K., et al. (2014). Telephone cognitive-behavioral therapy for obsessive-compulsive disorder: A randomized controlled non-inferiority trial with economic evaluation compared to face-to-face therapy. Journal of Clinical Psychiatry, 75(6), 574-582. https://doi.org/10.4088/JCP.13m08832
van den Heuvel, O., van Wingen, G., Soriano-Mas, C., et al. (2021). Cognitive-behavioral therapy for obsessive-compulsive disorder: Neural mechanisms and predictors of response to treatment in adults and youth populations from a neuroimaging perspective. Neuroscience and Biobehavioral Reviews, 124, 146-160. https://doi.org/10.1016/j.neubiorev2021
Visser, H., & van Minnen, A. (2018). Augmenting exposure therapy with cognitive restructuring for obsessive-compulsive disorder: A randomized clinical trial of its efficacy and mechanisms of change. Behaviour Research and Therapy, 108, 1-9. https://doi.org/10.1016/j.brat2018
Öst LG, Enebrink P, Finnes A, Ghaderi A, et al. (2022) Cognitive behavior therapy for obsessive-compulsive disorder in routine clinical care: A systematic review and meta-analysis. Behav Res Ther. 2022 Dec;159:104170. doi: 10.1016/j.brat.2022.104170.
Gragnani A, Zaccari V, Femia G, Pellegrini V, et al. (2022). Cognitive-Behavioral Treatment of Obsessive-Compulsive Disorder: The Results of a Naturalistic Outcomes Study. J Clin Med. 2022 May 13;11(10):2762. doi: 10.3390/jcm11102762.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2025 Rafael Hernández Pineda, Cristian Santiago Jácome Granda, Daysi Fernanda Pazmiño Lascano, Ángel Daniel Villegas Rassa, Andrea Carolina Cisneros Oñate, Jackeline Nicole Menéndez Sornoza, Vanessa Carolina Millán Rodríguez, Erika Johanna Buenaño Méndez

Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.


