Alteraciones neuropsicológicas en el trastorno obsesivo compulsivo refractario al tratamiento

Abstract

Obsessive compulsive disorder is one of the most disabling and chronic disorders, and it affects approximately 2,5% of the general population. It is characterized by repetitive, persistent and unwanted thoughts, and compulsive, ritualized, rigid and repetitive behaviors, that reduce the anxiety provoked by the obsessions. Approximately 40-60% of the patients affected by this disorder, do not respond to pharmacological and behavioral treatment. Moreover, up to 10% of the patients with obsessive compulsive disorder are considered refractory to treatment, because they do not respond to first line established treatments, either pharmacological or psychotherapeutic. Other more invasive techniques are normally considered for this subgroup, like deep brain stimulation or psychosurgery.In the last decades, a growing body of literature about the cognitive functioning of these patients, and neurobiological models, has emerged. Cognitive deficits in executive functions and speed of information processing are reported in patients with obsessive-compulsive disorder. Some studies have even suggested that speed deficits may underlie poor neuropsychological performance. In other cognitive domains, however, this hypothesis remains unanswered in both the general obsessive compulsive disorder population and the refractory subgroup. In addition, it is not clear whether such deficits are secondary to the clinical symptoms or may constitute a primary deficit...