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Resistência e refratariedade no transtorno obsessivo-compulsivo

2007; Associação Brasileira de Psiquiatria; Volume: 29; Issue: suppl 2 Linguagem: Inglês

10.1590/s1516-44462006005000059

1809-452X

Ygor Arzeno Ferrão, Juliana Belo Diniz, Antônio Carlos Lopes, Roseli Gedanke Shavitt, Benjamin D. Greenberg, Eurípedes C. Miguel,

Eating Disorders and Behaviors

Despite the existence of effective therapeutic alternatives for obsessive-compulsive disorder, a significant number of patients does not achieve or does not maintain remission after adequate treatment. The relief of these patients' suffering with the available treatments is a clinical challenge related to many unanswered questions. The objective of this literature review is to evaluate the current concepts of treatment resistance and refractoriness, to describe the intrinsic and extrinsic factors of obsessive-compulsive disorder's phenomenology that might influence treatment response to conventional treatment, and to present a fluxogram of therapeutic alternatives for resistant or refractory obsessive compulsive disorder patients.The literature evinces that intrinsic and/or extrinsic phenomenological aspects of obsessive-compulsive disorder may collaborate to the fact that, at least 30% of obsessive-compulsive disorder patients do not respond to conventional treatment. Several therapeutic or augmentation alternatives, psychopharmacological, biological or even psychotherapeutical exist, but more studies are necessary to evince the correct way to symptom remission.