Estimaciones e Implicaciones de la Prevalencia del Trastorno Obsesivo-Compulsivo: ¿Trastorno habitual con una distribución cosmopolita o estrategia infrecuente con una distribución septentrional?
DOI:
https://doi.org/10.24310/espsiescpsi.v8i1.13221Palabras clave:
Trastorno de personalidad obsesivo-compulsivo, Prevalencia, Epidemiología, Evolución, Selección equilibrada dependiente de la frecuencia negativa, HeredabilidadResumen
El DSM-V estima que la prevalencia del trastorno obsesivo-compulsivo oscila entre el 2,1 y el 7,9 por ciento, lo que lo convierte en uno de los trastornos de personalidad de mayor prevalencia en la población general. Sin embargo, la prevalencia del trastorno se suele publicar sin valorar las implicaciones de este hecho. Tras la revisión de las estimaciones que aparecen en varios estudios, este artículo analiza por qué se ha ignorado la prevalencia de este trastorno, cómo cambia este hecho los supuestos etiológicos y el modo en que las nuevas etiologías propuestas ayudan a comprender la prevalencia del trastorno obsesivo-compulsivo. La elevada prevalencia unida a la alta heredabilidad ponen en tela de juicio la etiología psicoanalítica e invalidan la clasificación psiquiátrica, y además sugieren que el trastorno obsesivo-compulsivo no es común, sino infrecuente. Siguiendo esta línea argumental, se utiliza la teoría evolucionista para ilustrar las condiciones bajo las que surge este fenotipo infrecuente y las leyes mecanicistas que lo mantienen en sus actuales proporciones. Tal y como se plantea en la discusión, cuando la elevada prevalencia del trastorno obsesivo-compulsivo se contextualiza dentro de un paradigma evolucionista, aflora la existencia de una biogeografía ecológicamente determinada de este trastorno.
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