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Clinical effectiveness of group cognitive-behavioral therapy (GCBT) versus fluoxetine in obsessive-compulsive disorder outpatients that could present additional psychiatric comorbidities was assessed. Patients (18–65 years; baseline Yale-Brown Obsessive-Compulsive-Scale [Y-BOCS] scores ≥ 16; potentially presenting additional psychiatric comorbidities) were sequentially allocated for treatment with GCBT (n = 70) or fluoxetine (n = 88). Mean Y-BOCS scores decreased by 23.13% in the GCBT and 21.54% in the SSRI groups (p = 0.875). Patients presented a mean of 2.7 psychiatric comorbidities, and 81.4% showed at least one additional disorder. A reduction of at least 35% in baseline Y-BOCS scores and CGI ratings of 1 (much better) or 2 (better) was achieved by 33.3% of GCBT patients and 27.7% in the SSRI group (p = 0.463). The Y-BOCS reduction was significantly lower in patients with one or more psychiatric comorbidities (21.15%, and 18.73%, respectively) than in those with pure OCD (34.62%; p = 0.034). Being male, having comorbidity of Major Depression, Social Phobia, or Dysthymia predicted a worse response to both treatments. Response rates to both treatments were similar and lower than reported in the literature, probably due to the broad inclusion criteria and the resulting sample more similar to the real world population.

Introduction:Findings suggest that obsessive-compulsive disorder (OCD) and related disorders, referred to as obsessive-compulsive spectrum disorders (OCSDs), are more common in patients with rheumatic fever (RF).Objectives:To determine whether RF or Sydenham's chorea increases the probability of anxiety disorders in the relatives of individuals with RF with and without SC.Methods:This was a case-control family study in which 98 probands and 389 first-degree relatives (FDRs) were assessed using structured psychiatric interviews. A Poisson regression model was used to determine whether the presence of any disorder in one family member influences the rate of disorders in the remaining family members.Results:Generalized anxiety disorder (GAD) occurred more frequently in the FDRs of RF probands than in those of control probands (P=.018). The presence of RF, GAD, or separation anxiety disorder in one family member significantly increased the chance of OCSDs in another member of the family.

Howard Kushner, one of the greatest historians on Tourette syndrome (TS) did an important review on the history of TS which served as the basis for this introduction (see Kushner, 1999, for review). He performed detailed research in which he personally translated several French documents, including the first article by Gilles de la Tourette, published in 1885 and which reports a case series of patients who presented a combination of multiple motor tics and “involuntary” vocalizations with the eventual appearance of eruptive cursing that he designated “coprolalia” (Tourette, 1885). Gilles de la Tourette labeled this disorder maladie des tics convulsifs avec coprolalie, insisting that it was distinct from choreas and hysterias. Based on nine patients’ case histories, Gilles de la Tourette concluded that, although its signs and symptoms might wax and wane, the disease ultimately resisted all interventions (Kushner, 1999). Many theories were postulated to explain the origin of this strange disease, such as psychologic (a type of hysteria), degenerative, infectious (a type of chorea, or rheumatic fever, or secondary to encephalitis), and hereditary. As a result, patients with similar medical histories and symptoms received different treatments depending on the philosophy and training of their particular physicians (Kushner and Howard, 2000).

Este artigo revisa a literatura sobre o transtorno obsessivocompulsivo com o objetivo de informar o estado atual da pesquisa científica nesse tema. Os autores citam a literatura internacional buscando enfatizar a pesquisa nacional, principalmente a pesquisa do seu grupo, o Projeto Transtornos do espectro Obsessivo-compulsivo. Este artículo repasa la literatura sobre el desorden obsesivo-compulsivo con el objetivo de informar el estado actual de la investigación científica en ese tema. Los autores mencionan la literatura internacional y dan énfasis a la investigación nacional, principalmente la investigación de su grupo, el PROTOC – Proyecto Trastornos del espectro Obsesivo-compulsivo. Cet article analyse la littérature sur trouble obsessionnel-compulsif et a pour but d’informer sur l’état courant de la recherche scientifique sur ce thème. Les auteurs citent la littérature internationale pour mettre en relief la recherche nationale, surtout la recherche de leur groupe, le PROTOC – le Projet des Troubles du Spectre Obsessionnelcompulsif. This article reviews the literature on obsessive-compulsive disorders with the objective of discussing the current state of the scientific research on this topic. The authors refer to the international literature and stress Brazilian research, especially that carried out by their own group, PROTOC (Obsessive-Compulsive Spectrum Disorders Project).