Os transtornos de personalidade e abordagens terapêuticas
DOI:
https://doi.org/10.25118/2763-9037.2022.v12.392Palavras-chave:
Transtornos da Personalidade, Conduta do Tratamento Medicamentoso, PsicoterapiaResumo
Introdução: O diagnóstico e a classificação de Transtorno de Personalidade são uma área de debate com alguma controvérsia e complexidade, seja quer no benefício da sua distribuição em categorias ou numa abordagem dimensional, seja no facto de se considerar uma verdadeira doença ou não e no quão prejudicial isso possa ser. O impacto funcional é nuclear da maioria destas patologias pelo que deve ser um componente central na avaliação e abordagem terapêutica. Objectivo: Rever as características dos Transtornos de Personalidade, identificar os traços maladaptivos de forma a melhor adaptar a respetiva terapêutica e analisar quais os tratamentos mais eficazes. Método: foi feita uma revisão sistemática com base na PubMed onde foi usado o termo MeSH “Transtorno de Personalidade”. Resultados: O Transtorno de Personalidade borderline é a que detém de maior evidência, sendo que os fármacos mais usados são os antipsicóticos, com eficácia evidenciada para a olanzapina, risperidona, haloperidol, tiotixeno e ainda no antidepressivo fluoxetina. Nos Transtornos de Personalidade do Cluster C e Transtorno Narcísico, concluiu-se que uma abordagem cognitiva e psicodinâmica resulta em efeitos positivos médios a elevados, embora seja claro que este subtipo de personalidade beneficie mais com a mesma. Conclusão: A evidência sugere que Transtornos de Personalidade comórbidos ou latentes estão associados a uma menor adesão ao tratamento e a piores outcomes quando se trata de doenças do Eixo 1. Conclui-se que, na generalidade, não há informação suficiente para ser possível tirar conclusões quanto à eficácia das intervenções farmacológicas, sendo a maioria da evidência relativa ao Transtorno de Personalidade Borderline.
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