PSICOPATOLOGIA DO EMAGRECIMENTO EXTREMO: INTERAÇÃO ENTRE ANSIEDADE, PERFECCIONISMO E CONTROLE ALIMENTAR
DOI:
https://doi.org/10.18623/rvd.v23.8113Keywords:
Anorexia Nervosa, Perfeccionismo, Transtornos de AnsiedadeAbstract
Introdução: Transtornos alimentares com emagrecimento extremo, notadamente a anorexia nervosa, apresentam a maior taxa de mortalidade entre os transtornos psiquiátricos e são caracterizados por psicopatologia multidimensional, na qual ansiedade, perfeccionismo e controle alimentar rígido operam como fatores centrais de manutenção. Objetivo: Analisar a interação entre ansiedade, perfeccionismo e controle alimentar em quadros de emagrecimento extremo, com base em evidências publicadas entre 2019 e 2026. Métodos: Revisão sistematizada da literatura conduzida nas bases PubMed/MEDLINE, Scopus, Web of Science, PsycINFO e LILACS, utilizando descritores DeCS/MeSH combinados por operadores booleanos, incluindo "Anorexia Nervosa", "Eating Disorders", "Perfectionism", "Anxiety Disorders" e "Dietary Restraint". Incluíram-se estudos originais e revisões sistemáticas com amostras humanas, em português, inglês ou espanhol. A qualidade metodológica foi avaliada por ferramentas do Joanna Briggs Institute, com síntese qualitativa conforme o PRISMA 2020. Resultados: Foram incluídos 22 estudos, majoritariamente transversais, envolvendo pacientes predominantemente do sexo feminino, adolescentes e adultas jovens. A prevalência de transtornos ansiosos comórbidos variou de 39,7% a 71,3%, com predomínio de transtorno de ansiedade generalizada (46,8%) e transtorno de ansiedade social (42,1%). Escores de perfeccionismo autoorientado e socialmente prescrito mostraram-se significativamente elevados em relação a controles, com correlação forte com ansiedade traço e restrição alimentar. Modelos de mediação evidenciaram a ansiedade como variável intermediária entre perfeccionismo e controle alimentar rígido. Conclusão: A interação dinâmica entre ansiedade, perfeccionismo e controle alimentar sustenta a manutenção do quadro, com implicações diretas para intervenções psicoterápicas transdiagnósticas focadas simultaneamente nesses três domínios.
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