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Autoayuda con contacto mínimo con el terapeuta para el trastorno obsesivo-compulsivo: una revisión

Published online by Cambridge University Press:  12 May 2020

David Mataix-Cols
Affiliation:
Instituto de Psiquiatría, King's College London, PO BOX 69, De Crespigny Park, Londres, SE5 8AF, Reino Unido
Isaac M. Marks
Affiliation:
Instituto de Psiquiatría, King's College London, PO BOX 69, De Crespigny Park, Londres, SE5 8AF, Reino Unido
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Resumen

Aunque hay tratamientos psicológicos y farmacológicos eficaces para el trastorno obsesivo-compulsivo (TOC), muchos pacientes reciben tratamiento inadecuado o no lo reciben en absoluto. Proporcionar una guía de auto-tratamiento eficaz puede incrementar el número de pacientes que reciben ayuda. En esta revisión, se realizaron búsquedas en bases de datos y manuales en las publicaciones de estudios de casos, ensayos al descubierto y ensayos controlados distribuidos al azar (ECDA) de biblioterapia, grupos de autoayuda, teleatención y autoayuda asistida por ordenador para el TOC. No encontramos ECDA de biblioterapia o grupos de autoayuda para el TOC. Tres estudios al descubierto mostraron la eficacia de instrucciones de exposición breve y prevención de rituales (EPR) dadas por un terapeuta en directo por teléfono. Un programa de ordenador de EPR vicaria fue eficaz en un pequeño estudio al descubierto. La autoayuda completamente interactiva asistida por ordenador por EPR para el TOC fue eficaz en dos estudios al descubierto y un gran ECDA multicéntrico, y en un ECDA pequeño el cumplimiento y la evolución con ese programa se reforzó por un apoyo breve programado de un clínico. Aunque se necesita más investigación, los enfoques de autoayuda tienen el potencial de ayudar a muchos más pacientes que, en otro caso, podrían recibir tratamiento inadecuado o no recibirlo en absoluto. Su difusión podría ahorrar recursos utilizados por profesionales sanitarios. Proponemos un modelo escalonado de atención para el tratamiento del TOC.

Type
Revisión
Copyright
Copyright © European Psychiatric Association 2006

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References

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