{"id":3229,"date":"2020-07-01T15:47:43","date_gmt":"2020-07-01T15:47:43","guid":{"rendered":"https:\/\/curesz.org\/?p=3229"},"modified":"2020-08-08T17:53:42","modified_gmt":"2020-08-08T17:53:42","slug":"talk-to-your-doctor-combining-psychotherapy-with-medications","status":"publish","type":"post","link":"https:\/\/curesz.org\/pt_pt\/2020\/07\/01\/talk-to-your-doctor-combining-psychotherapy-with-medications\/","title":{"rendered":"Fale com o seu m\u00e9dico: combinando psicoterapia com medicamentos"},"content":{"rendered":"
\"\"

Justin McCutcheon, m\u00e9dico<\/p><\/div>\n

A parte mais gratificante do meu trabalho como psiquiatra \u00e9 praticar psicoterapia, principalmente quando posso ajudar pacientes com problemas mentais graves, como esquizofrenia. Fico desapontado quando ou\u00e7o as pessoas sugerirem que a psicoterapia realmente n\u00e3o \u00e9 o tratamento certo para pacientes com esquizofrenia1<\/sup>. Meu objetivo neste artigo \u00e9 informar aos pacientes, suas fam\u00edlias e m\u00e9dicos que a psicoterapia pode ser uma parte muito importante do plano de recupera\u00e7\u00e3o de um paciente esquizofr\u00eanico. A lista de poss\u00edveis terapias estudadas como tratamento para a esquizofrenia \u00e9 vasta, e a escolha de um tipo de terapia depende de voc\u00ea e de seus objetivos terap\u00eauticos pessoais \u00fanicos.<\/p>\n

A terapia cognitivo-comportamental (TCC) \u00e9 a terapia mais amplamente estudada para a esquizofrenia e envolve primeiro estar mais consciente de seus pensamentos (cogni\u00e7\u00f5es), sentimentos e comportamentos. Voc\u00ea ent\u00e3o trabalha com seu terapeuta para normalizar e entender que alguns de seus sintomas anteriores ou atuais de esquizofrenia (como del\u00edrios, alucina\u00e7\u00f5es ou pensamento desorganizado) fazem parte de sua condi\u00e7\u00e3o psiqui\u00e1trica. Voc\u00ea pode compartilhar essas experi\u00eancias problem\u00e1ticas sem ser julgado e usar a TCC para melhorar sua compreens\u00e3o e habilidades de enfrentamento. Estudos publicados relatam que os pacientes que recebem TCC apresentam melhorias nos sintomas positivos (iepsic\u00f3ticos) (alucina\u00e7\u00f5es, del\u00edrios), sintomas negativos (falta de motiva\u00e7\u00e3o, express\u00e3o facial embotada, retraimento social), funcionamento, humor, desesperan\u00e7a e ansiedade social2<\/sup>.<\/p>\n

A terapia de suporte (ST) pode fornecer a voc\u00ea um relacionamento caloroso e de apoio, onde os problemas atuais podem ser discutidos livremente e trabalhados em parceria com seu provedor. Geralmente \u00e9 menos estruturado do que outras formas de terapia, e as evid\u00eancias cient\u00edficas de sua efic\u00e1cia n\u00e3o s\u00e3o t\u00e3o fortes quanto outros tratamentos3<\/sup>.<\/p>\n

O Treinamento de Habilidades Sociais (SST) \u00e9 uma terapia focada em aprender e praticar habilidades sociais espec\u00edficas em um esfor\u00e7o para melhorar sua vida, e tamb\u00e9m envolve fazer e alcan\u00e7ar seus objetivos individuais para a recupera\u00e7\u00e3o (ou seja, conseguir um emprego, conhecer novas pessoas, aumentar as atividades agrad\u00e1veis)4<\/sup>.<\/p>\n

A Remedia\u00e7\u00e3o Cognitiva (CR) trabalha para melhorar ou encontrar \u201csolu\u00e7\u00f5es alternativas\u201d para os problemas de pensamento que geralmente ocorrem devido \u00e0 esquizofrenia. Exemplos de metas de RC podem melhorar a concentra\u00e7\u00e3o, a mem\u00f3ria, a consci\u00eancia social ou a capacidade de \u201cpensar sobre o seu pensamento\u201d (metacogni\u00e7\u00e3o)5<\/sup>.<\/p>\n

A Psicoeduca\u00e7\u00e3o (PE) fornece informa\u00e7\u00f5es aos pacientes e a Interven\u00e7\u00e3o Familiar (FI) fornece informa\u00e7\u00f5es aos pacientes e suas fam\u00edlias sobre o diagn\u00f3stico, expectativas realistas e problemas ou conflitos comuns6<\/sup>.<\/p>\n

A psicoterapia psicodin\u00e2mica envolve explorar suas experi\u00eancias de vidas passadas e aumentar sua compreens\u00e3o sobre como conflitos emocionais anteriores podem estar (inconscientemente) influenciando seu comportamento atual. Estudos mostram que a psicoterapia psicodin\u00e2mica pode fornecer melhorias em um \u201cproblema-alvo\u201d, n\u00edvel de sintoma e funcionamento social7<\/sup>. No entanto, pode n\u00e3o ser adequado para todos os pacientes.<\/p>\n

Em minha pr\u00e1tica cl\u00ednica, costumo usar TCC para muitos de meus pacientes. Estudei e aprendi outras formas de terapia, mas descobri que a TCC \u00e9 a maneira mais flex\u00edvel e eficiente de ajudar meus pacientes a prosperar. Um paciente meu com esquizofrenia (\u201cJeff\u201d) fez alguns coment\u00e1rios sobre como a psicoterapia ajudou em sua jornada de recupera\u00e7\u00e3o, e encerrarei este artigo com seus coment\u00e1rios. Foi um prazer trabalhar com Jeff e estou incrivelmente orgulhoso de seu progresso!<\/p>\n

\u201cA terapia me ajudou a entender muito melhor a mim mesma e meus sintomas. Eu costumava ver o mundo como um lugar muito mais assustador e me sentia muito mais paran\u00f3ico do que agora. Ainda ou\u00e7o vozes todos os dias, mas gra\u00e7as \u00e0 terapia as entendo, reajo a elas de uma forma totalmente diferente e elas me incomodam muito menos. Assim que consigo usar a TCC para resolver um problema que est\u00e1 me incomodando, percebo uma queda significativa no meu n\u00edvel de estresse. Sou muito mais capaz de manter a calma em situa\u00e7\u00f5es em que h\u00e1 muitas pessoas, ru\u00eddos e luzes fortes. Na terapia consigo um espa\u00e7o para discutir coisas que me s\u00e3o muito dif\u00edceis de falar. Construir confian\u00e7a foi essencial para mim e me deu a oportunidade de desabafar. Por fim, houve momentos em minha vida em que seria muito f\u00e1cil simplesmente \u201cdesistir\u201d, mas fazer essa terapia me ajudou a manter a esperan\u00e7a e a motiva\u00e7\u00e3o. N\u00e3o me sinto \u201ccurado\u201d, mas estou lidando com minha vida muito melhor do que antes!\u201d<\/p>\n

 <\/p>\n

Refer\u00eancias<\/p>\n

    \n
  1. Kuller, AM, Ott, BD, Goisman, RM, Wainwright, LD, & Rabin, RJ (2010). Terapia cognitivo-comportamental e esquizofrenia: uma pesquisa de pr\u00e1ticas cl\u00ednicas e pontos de vista sobre a efic\u00e1cia nos Estados Unidos e no Reino Unido. Revista comunit\u00e1ria de sa\u00fade mental<\/em>, 46<\/em>(1), 2-9.<\/li>\n
  2. Wykes, T., Steel, C., Everitt, B., & Tarrier, N. (2008). Terapia cognitivo-comportamental para esquizofrenia: tamanhos de efeito, modelos cl\u00ednicos e rigor metodol\u00f3gico. boletim esquizofrenia<\/em>, 34<\/em>(3), 523-537.<\/li>\n
  3. Buckley, LA, Maayan, N., Soares\u2010Weiser, K., & Adams, CE (2015). Terapia de suporte para esquizofrenia. Banco de Dados Cochrane de Revis\u00f5es Sistem\u00e1ticas<\/em>, (4).<\/li>\n
  4. Granholm, E. & Harvey, PD (2018). Treinamento de habilidades sociais para sintomas negativos da esquizofrenia. boletim esquizofrenia<\/em>, 44<\/em>(3), 472-474.<\/li>\n
  5. Barlati, S., Deste, G., De Peri, L., Ariu, C., & Vita, A. (2013). Remedia\u00e7\u00e3o cognitiva na esquizofrenia: situa\u00e7\u00e3o atual e perspectivas futuras. Pesquisa e tratamento da esquizofrenia<\/em>, 2013<\/em>.<\/li>\n
  6. Gir\u00f3n, M., Nova-Fern\u00e1ndez, F., Ma\u00f1\u00e1-Alvarenga, S., Nolasco, A., Molina-Habas, A., Fern\u00e1ndez-Ya\u00f1ez, A., \u2026 & G\u00f3mez-Beneyto, M. (2015). Como a interven\u00e7\u00e3o familiar melhora o resultado de pessoas com esquizofrenia?. Psiquiatria social e epidemiologia psiqui\u00e1trica, 50(3), 379-387.<\/li>\n
  7. Leichsenring, F., Rabung, S., & Leibing, E. (2004). A efic\u00e1cia da psicoterapia psicodin\u00e2mica de curta dura\u00e7\u00e3o em transtornos psiqui\u00e1tricos espec\u00edficos: uma meta-an\u00e1lise. Arquivos de psiquiatria geral<\/em>, 61<\/em>(12), 1208-1216.<\/li>\n<\/ol>","protected":false},"excerpt":{"rendered":"

    The most rewarding part of my job as a psychiatrist […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3229","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"acf":[],"yoast_head":"\nTalk to Your Doctor: Combining Psychotherapy with Medications - CURESZ Foundation<\/title>\n<meta name=\"description\" content=\"Patients, their families and their practitioners should know that psychotherapy can be a very important part of a patient's recovery from schizophrenia.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/curesz.org\/pt_pt\/2020\/07\/01\/talk-to-your-doctor-combining-psychotherapy-with-medications\/\" \/>\n<meta property=\"og:locale\" content=\"pt_PT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Talk to Your Doctor: Combining Psychotherapy with Medications - 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