Pervasive developmental disorders are now commonly referred to as autism spectrum disorders (ASDs). ASDs present with a range of severity and impairments, and often are a cause of severe disability, representing a major public health concern. The diagnostic criteria require delays or abnormal functioning in social interaction, language, and/or imaginative play within the first 3 years of life, resulting in a deviation from the developmental pattern expected for the age. Because establishing a diagnosis of ASD is possible as early as 18-24 months of age, clinicians should strive to identify and begin intervention in children with ASD as soon as signs are manifest. Increasing efforts are underway to make ASD screening universal in pediatric healthcare. Given the crucial importance of early identification and multiple modalities of treatment for ASD, this review will summarize the diagnostic criteria, key areas for assessment by clinicians, specific scales and instruments for assessment, and discussion of evidence-based treatment programs and the role of specific drug therapies for symptom management.
Objective: To describe and discuss evidence-based articles on the neurobiology of obsessive-compulsive disorder and Tourette syndrome.
Sources of data:A review of the most relevant papers on the phenomenology, neuroanatomy, neuroimaging, genetic and immunological aspects of these two disorders was performed.Summary of the findings: Ritualistic behaviors and repetitive thoughts have been extensively studied in the last years. The definitions of obsessive-compulsive disorder and Tourette syndrome emphasize the existence of a continuum of symptoms, with high prevalence in the general population. Neurobiological findings have implicated genetic and immunological factors in the etiology of these two disorders.
ResumoObjetivo: Revisar as teorias e evidências das bases neurobiológi-cas do transtorno obsessivo-compulsivo e da síndrome de Tourette.
Fontes dos dados:Revisão dos estudos que investigam a neuroanatomia, neuroimagem, genética e imunologia desses transtornos.
Síntese dos dados:Os comportamentos ritualísticos e pensamentos repetitivos têm sido cada vez mais estudados em nosso meio. As definições dessas entidades formam um continuum espectral de sintomas com prevalência significativa na população.Conclusões: Os avanços das neurociências possibilitaram a exploração dos aspectos genéticos do sistema nervoso central e seu funcionamento, fornecendo novas perspectivas para o tratamento de pacientes com transtorno obsessivo-compulsivo e síndrome de Tourette. As bases neurobiológicas do transtorno obsessivo-compulsivo e da síndrome de Tourette
2008ii DEDICATÓRIA Aos meus pacientes, que me permitem aprender com a experiência durante todos os dias da minha prática profissional.Aos pais das crianças com Autismo Infantil, Síndrome de Down e outros transtornos psiquiátricos, que possibilitaram a realização deste trabalho.iii
AGRADECIMENTOSAos meus pais, Sérgio e Izaura, que me mostraram a importância do estudo por meio da dedicação e da seriedade com que sempre exerceram as suas profissões.Aos meus irmãos, Guilherme e Ana Paula, por me apoiarem incondicionalmente.Ao Prof. Dr. Marcos Tomanik Mercadante, pela orientação clínica e acadêmica, sempre segura e generosa, e por reconhecer e valorizar a minha capacidade para o trabalho durante todos estes anos.A Daniela Kurcgant pela amizade, apoio e incentivo sempre.Ao amigo Alessandro Ferrari Jacinto, pelo apoio e incentivo com que sempre pude contar.A Euthymia Brandão de Almeida Prado, pela amizade e generosidade sempre disponíveis durante todo este percurso.Ao estatístico Eduardo Yoshio Nakano, que me ajudou na elaboração de todo o trabalho. Sem sua colaboração, não teria sido possível realizá-lo.À amiga Ana Soledade Graeff Martins, pelo exemplo de determinação, seriedade e ética com que exerce suas atividades acadêmicas.Ao amigo Leandro André de Souza, que me ajudou no que foi preciso na elaboração deste trabalho. À Sra. Eliza Fukushima, pelo apoio e pela paciência a mim dedicados.
Objective: To describe and discuss evidence-based articles on the neurobiology of obsessive-compulsive disorder and Tourette syndrome.
Sources of data:A review of the most relevant papers on the phenomenology, neuroanatomy, neuroimaging, genetic and immunological aspects of these two disorders was performed.Summary of the findings: Ritualistic behaviors and repetitive thoughts have been extensively studied in the last years. The definitions of obsessive-compulsive disorder and Tourette syndrome emphasize the existence of a continuum of symptoms, with high prevalence in the general population. Neurobiological findings have implicated genetic and immunological factors in the etiology of these two disorders.Conclusions: Advances in neuroscience triggered genetic and immunological research studies, allowing new perspectives on the treatment of obsessive-compulsive disorder and Tourette syndrome patients.
Advances in neuroscience triggered genetic and immunological research studies, allowing new perspectives on the treatment of obsessive-compulsive disorder and Tourette syndrome patients.
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