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A neuropsicologia da perturbação obsessivo-compulsiva: uma meta-análise
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Abstract(s)
Nos últimos anos, observou-se um aumento significativo no número de estudos que procuram caraterizar o perfil neuropsicológico em pacientes com Perturbação Obsessivo-Compulsiva (POC), produzindo resultados inconsistentes. Com o objetivo de resumir de forma quantitativa os resultados de estudos prévios, realizámos uma meta-análise que abrangeu um total de 96 estudos e incluiu uma amostra composta por 2995 sujeitos diagnosticados com POC e 3235 indivíduos no grupo de controlo. Foram observados tamanhos do efeito estatisticamente significativos na maioria dos domínios neuropsicológicos avaliados.
Foram encontrados efeitos de maior magnitude em provas que avaliam a abstração não-verbal, atenção e memória não-verbal. Em simultâneo, os tamanhos do efeito médio foram observados em testes de velocidade de processamento, funções executivas, flexibilidade cognitiva, controlo inibitório, memória de trabalho não-verbal e memória episódica. Por outro lado, os efeitos de menor magnitude foram observados na abstração verbal, memória de trabalho verbal, memória semântica e capacidade visuoconstrutiva. A maioria destes efeitos são mais acentuados quanto maior a gravidade da POC, confirmando o comprometimento cognitivo nesta perturbação. Os resultados são analisados em termos da sua relevância clínica, bem como as suas implicações para os modelos neurobiológicos da POC e as considerações metodológicas necessárias.
In recent years, there has be en a significant increase in the number of studies aiming to characterize the neuropsychological profile of patients with Obsessive Compulsive Disorder (OCD), yielding inconsistent results. To quantitatively sum m arize the findings from previous studies, we conducted a meta analysis that encompassed a total of 96 studies, including a sample of 2995 individuals diagnosed with OCD and 3235 individuals in the control group. Statistically significant effect sizes were observed in most of the assessed neuropsychological domains. Larger effect sizes were found in tests assessing non verbal abstraction, attention, and non verbal memory. Meanwhile, m e dium effect sizes were observed in tests of processing speed, executive functions, cognitive flexibility, inhibitory control, non verbal working memory and episodic memory. On the other hand, smalle r effect sizes were observed in verbal abstraction, verbal working memory, semantic mem ory and visuoconstructional ability. Most of these effects are more pronounced with increasing severity of OCD, confirming cognitive impairment in this disorder. The results are discussed in terms of their clinical relevance, as well as their implications for the neurobiological models of OCD and the necessary methodological considerations.
In recent years, there has be en a significant increase in the number of studies aiming to characterize the neuropsychological profile of patients with Obsessive Compulsive Disorder (OCD), yielding inconsistent results. To quantitatively sum m arize the findings from previous studies, we conducted a meta analysis that encompassed a total of 96 studies, including a sample of 2995 individuals diagnosed with OCD and 3235 individuals in the control group. Statistically significant effect sizes were observed in most of the assessed neuropsychological domains. Larger effect sizes were found in tests assessing non verbal abstraction, attention, and non verbal memory. Meanwhile, m e dium effect sizes were observed in tests of processing speed, executive functions, cognitive flexibility, inhibitory control, non verbal working memory and episodic memory. On the other hand, smalle r effect sizes were observed in verbal abstraction, verbal working memory, semantic mem ory and visuoconstructional ability. Most of these effects are more pronounced with increasing severity of OCD, confirming cognitive impairment in this disorder. The results are discussed in terms of their clinical relevance, as well as their implications for the neurobiological models of OCD and the necessary methodological considerations.
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Keywords
Perturbação obsessivo-compulsiva Poc Neuropsicologia Cognição Meta-análise