Frotteruismo e Cleptomania na Perturbação do Espectro do Autismo de Alto Funcionamento: Caso Clínico
DOI:
https://doi.org/10.51338/rppsm.505Palavras-chave:
Perturbação do Espectro do Autismo, Perturbações Disruptivas de Controlo dos Impulsos e de CondutaResumo
As vulnerabilidades inatas nas perturbações do espectro do autismo (PEA) aumentam o risco de comorbilidades psiquiátricas e questões de enquadramento legal. Os défices persistentes na comunicação social, os interesses restritos e repetitivos, ou as particularidades sensoriais podem facilitar o aparecimento de comportamentos desviantes. Este caso clínico descreve a história de um jovem de 22 anos que exibia comportamentos particulares categorizados em frotteurismo e cleptomania. A natureza impulsiva destes comportamentos era também ela consistente com padrões repetitivos e estereotipados. A referência a prévias dificuldades a nível social, sobretudo na vertente da comunicação foi proeminente, tendo conduzido à suspeita do diagnóstico de PEA. Este caso apresenta duas condições raras, comórbidas com a PEA, cujas implicações a nível legal podem afetar severamente a vida dos indivíduos. A importância desta associação aplica-se sobretudo em PEA de alto funcionamento, devido à probabilidade destes indivíduos chegarem não diagnosticados à vida adulta. O diagnóstico de PEA mostra- -se pertinente sobretudo no campo da psiquiatria forense, pois a aferição diagnóstica permitirá o acesso a intervenções adequadas a nível da educação sexual e competências sociais.Downloads
Referências
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington: APA; 2013.
Elsabbagh M, Divan G, Koh YJ, Kim YS, Kauchali S, Marcín C, et al. Global prevalence of autism and other pervasive developmental disorders. Autism Res. 2012;5:160-79.
Lyall K, Croen L, Daniels J, Fallin MD, Ladd-Acosta C, Lee BK, et al. The changing epidemiology of autism spectrum disorders. Annu Rev Public Health. 2017;38:81-102. doi: 10.1146/annurev-publhealth-031816-044318.
McPartland J, Volkmar FR. Autism and related disorders. Handb Clin Neurol. 2012;106:407-18. doi: 10.1016/B978-0-444-64148-9.00010-7.
Tromans S, Chester V, Kiani R, Alexander R, Brugha T. The prevalence of autism spectrum disorders in adult psychiatric inpatients: a systematic review. Clin Pract Epidemiol Ment Health. 2018;14:177-87. doi: 10.2174/1745017901814010177.
Hossain MM, Khan N, Sultana A, Ma P, McKyer ELJ, Ahmed HU, et al. Prevalence of comorbid psychiatric disorders among people with autism spectrum disorder: An umbrella review of systematic reviews and meta-analyses. Psychiatry Res. 2020;287:112922. doi: 10.1016/j.psychres.2020.112922.
Tager-Flusberg H. The origins of social impairments in autism spectrum disorder: studies of infants at risk. Neural Netw. 2010;23:1072-6.
Fernandes LC, Gillberg CI, Cederlund M, Hagberg B, Gillberg C, Billstedt E. Aspects of sexuality in adolescents and adults diagnosed with autism spectrum disorders in childhood. J Autism Dev Disord. 2016;46:3155-65. doi: 10.1007/s10803-016-2855-9.
Schöttle D, Briken P, Tüscher O, Turner D. Sexuality in autism: hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder. Dialogues Clin Neurosci. 2017;19:381-93. doi: 10.31887/DCNS.2017.19.4/dschoettle.
Bhatia K, Parekh U. Frotteurism. In: StatPearls. Treasure Island: StatPearls Publishing; 2022.
Patra AP, Bharadwaj B, Shaha KK, Das S, Rayamane AP, Tripathi CS. Impulsive frotteurism: a case report. Med Sci Law. 2013;53:235-8.
Zhang ZH, Huang FR, Liu DH. Kleptomania: Recent Advances in Symptoms, Etiology and Treatment. Curr Med Sci. 2018;38:937-40. doi: 10.1007/ s11596-018-1966-2.
Lord C, Rutter M, DiLavore P, Risi S, Gotham K, Bishop S. Autism Diagnostic Observation Schedule. 2nd ed. Torrance: Western Psychological Services; 2012.
Lord C, Rutter M, DiLavore P, Risi S, Gotham K, Bishop S. ADOS-2. Escala de Observación para el Diagnóstico del Autismo - 2. Manual (Parte 1): Módulos 1-4 (T. Luque, adaptadora). Madrid: TEA Ediciones; 2015.
Lai MC, Kassee C, Besney R, Bonato S, Hull L, Mandy W, et al. Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. Lancet Psychiatry. 2019;6:819-29. doi: 10.1016/S2215-0366(19)30289-5.
Creaby-Attwood A, Allely CS. A psycho-legal perspective on sexual offending in individuals with autism Spectrum disorder. Int J Law Psychiatry. 2017;55:72-80. doi: 10.1016/j.ijlp.2017.10.009.
Frith U, Happé F. Autism: beyond “theory of mind”. Cognition. 1994;50:115-32.
Haskins BG, Silva JA. Asperger’s disorder and criminal behavior: forensic-psychiatric considerations. J Am Acad Psychiatry Law. 2006;34:374-84.
Allely CS, Creaby-Attwood A. Sexual offending and autism spectrum disorders. J Intellect Disabil Offending Behav. 2016;7:35–51.
Murrie DC, Warren JI, Kristiansson M, Dietz PE. Asperger’s syndrome in forensic settings. Int J Forensic Ment Health. 2002;1:59–70.
Grant JE, Kim SW. Brain circuitry of compulsivity and impulsivity. CNS Spectr. 2014;19:21-7. doi: 10.1017/ S109285291300028X.
Mogavero MC. Autism, sexual offending, and the criminal justice system. J Intellect Disabil Offending Behav. 2016;7:116–26.
Lussier P, Piche L. Frotteurism: psychopathology and theory. In: Laws DR, O’Donohue WT, editors. Sexual deviance. Theory, assessment, and treatment. 2nd ed. New York: Guilford; 2008. p. 131–49.
Joyal CC, Carpentier J. The Prevalence of Paraphilic Interests and Behaviors in the General Population: A Provincial Survey. J Sex Res. 2017;54:161-71. doi: 10.1080/00224499.2016.1139034.
