Insight as a Predictor of Treatment Outcome in Behavioral Group Treatment for Obsessive–Compulsive Disorder

The presence of poor insight into the senselessness of symptoms of obsessive–compulsive disorder (OCD) has been theoretically linked to poor treatment response, yet few studies have examined this question. This study examined the role of poor insight in 69 OCD patients, who completed 7 weeks of cognitive behavioral group therapy. Participants completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and other measures of psychopathology. Insight was measured using interviewer ratings on an item of the Y-BOCS and participants were grouped as having “poor” or “adequate” insight. The analyses revealed that, after pre-treatment levels of OCD severity, depression, and medication status, were controlled, patients with adequate insight experienced better post-treatment outcomes than those with poor insight. These results suggest that patients with poorer insight can still benefit from treatment, but may experience a less favorable outcome than patients with better insight. Implications for the treatment of OCD are discussed.