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Estudo retrospectivo da psicoterapia comportamental em agorafóbicos

Authors: HJM, Unidade de Psicoterapia Intensiva;

Estudo retrospectivo da psicoterapia comportamental em agorafóbicos

Abstract

Os autores apresentam os resultados de um estudo retrospectivo, da aplicação de técnicas da terapia do comportamento em dez doentes agorafóbicos, na Unidade de Psicoterapia Intensiva do Hospital Júlio de Matos. O estudo foi realizado sobre uma amostra de três homens e sete mulheres, considerados muito incapacitados. Cinco estavam incapacitados de sair de casa sozinhos. A duração média da doença era de onze anos, variando entre um ano e 47 anos. A avaliação dos doentes foi feita no início e no fim do tratamento e numa catamnese que variou entre um mês e três anos e sete meses. Os métodos de avaliação utilizados foram: auto-avaliador e observação independente por um psiquiatra exterior à consulta. As técnicas usadas na terapia foram: exposição em imaginação e ao vivo, exposição gradual, modelagem, dessensibilização sistemática, intenção paradoxal, controle de ansiedade, automonitonização. A duração média do tratamento foi de cinco meses. Os resultados obtidos no fim do tratamento foram os seguintes: quatro doentes «muito melhorados », cinco «melhorados» e um «na mesma », verificando-se uma estabilização geral dos efeitos do tratamento. Embora a amostra seja muito pequena para ser significativa, foi no entanto concluído que os agora fóbicos parecem requerer uma duração de tratamento prolongada, e que a psicoterapia comportamental foi bem aceite pelos doentes. Em nenhum caso se verificou o aparecimento de novos sintomas durante ou após o tratamento. O facto de a maioria ter um grande número de problemas sociais e domésticos pode significar que, para além de uma primeira fase da utilização de técnicas comportameniais, seja benéfica uma segunda foi de intervenção do tipo familiar e social. Os autores finalizam com uma melhor consciência das dificuldades metodológicas encontradas e dos esforços que são necessários fazer-se para melhorar a qualidade científica da sua abordagem experimental.------ABSTRACT------The authors present the results of a retrospective study of behavioural psychotherapy with ten agoraphobic patients, operationally defined as being phobic in the following situations: leaving home, open spaces, crowds, closed in spaces and public transports. They were treated as outpatients in the Intensive Psychotherapy Unit of the Júlio de Matos Hospital. The study was conducted with a sample of three men and seven women, all considered to be severely incapacitated (five could not leave home on their own). The average duration of the illness was eleven years, ranging from one year and a half to forty-seven years. The assessment of the patients was carried out in the beginning and at the end of the treatment and in follow-up, which varied from one month to three years and seven months. The methods of assessment were: self-raiting scales and a psychiatric evaluation, conducted by a doctor, external to the Unit. The techniques used in the therapy were: Flooding «in imagination» and «in vivo», gradual exposure, modelling, systematic desensitization, paradoxical intention, anxiety control, and self-monitorization. The average duration of the treatment was five months. The results obtained at the end of the treatment were the following: four patients «much improved»: five «improved»; one «no change»). In the follow-up interview: five «much improved)); four «improved»; one «no change». At follow-up we also found a general stability in the effects of the treatment. Although the sample was too small to be significant it was,nevertheless, concluded that agoraphobics seem to require prolonged treatment, and that behavioural psychotherapy was well accepted by the patients. None of the patients presented new symptoms, during or after the treatment. Due to the large proportion of social and domestic problems found in the majority of the patients, we suggest that after this first phase of treatment it would be beneficial to help them in those problems using a more global psychiatric approach.

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
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