Insight in adults with obsessive–compulsive disorder
Section snippets
Participants
Study enrollment included 130 individuals with OCD (49% female; mean age = 31.8 years [SD = 12.7]; range = 18 to 68 years) who presented to one of two specialty OCD clinics for treatment. All participants were diagnosed with OCD according to DSM-IV-TR criteria by a licensed psychologist. A second clinical psychologist independently confirmed the diagnosis of OCD. The Anxiety Disorder Interview Schedule for the DSM-IV [ADIS-IV; 35] was administered by a trained research assistant to all participants
Aim 1: Associations between Insight and Indices of OCD Severity and OCD Symptom Resistance and/or Control
Spearman’s correlations between the insight item (number 11) on the Y-BOCS and indices of OCD severity are presented in Table 1. As predicted, level of insight was positively and moderately correlated with overall symptom severity across several indices, including the Y-BOCS total score, the CGI-S, and the NIMH-GOCS, such that poorer insight was associated with greater severity on these measures. Additionally, poor insight was associated with worse ability to resist and control OCD symptoms
Discussion
We examined clinical correlates of insight using a large sample of adults with OCD. Approximately 18% of the sample exhibited low insight, which is similar to what others have found [e.g., [6], [8], [16]]. Consistent with others [8], [9], [11], [12], [13], [14], [15], [16], [17], [18] level of insight was positively but moderately correlated with overall symptom severity across several indices including the Y-BOCS total score, the CGI-S, and the NIMH-GOCS, such that poorer insight was
Acknowledgment
We would like to acknowledge Scott Baldwin for his contribution of assistance with statistical analyses and Gary Geffken, Tanya Murphy, and Wayne Goodman for their contributions in data collection.
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Poor Insight in Obsessive-Compulsive Disorder as a Multifaceted Phenomenon: Evidence From Brain Activation During Symptom Provocation
2023, Biological Psychiatry: Cognitive Neuroscience and NeuroimagingObsessive-Compulsive Disorder: Diagnosis, Clinical Features, Nosology, and Epidemiology
2023, Psychiatric Clinics of North AmericaCitation Excerpt :As stated above, degree of insight should be specified when making an OCD diagnosis. In adults with OCD, 14% to 30% have poor or absent insight17 and poor insight has been associated with more severe OCD,17,18 a chronic course,19 and poorer treatment outcome,20 although findings for treatment outcome are inconsistent.14 On average, insight seems to be slightly better in youth: around one in 10 youth with OCD exhibits poor or absent insight, and poor insight does not predict outcome of cognitive-behavioral therapy.14
Poor insight in obsessive compulsive disorder (OCD): Associations with empathic concern and emotion recognition
2021, Psychiatry ResearchCitation Excerpt :Poor insight has been linked to symptoms of contamination/cleaning and symmetry/ordering/counting (Jakubovski et al., 2011; Hazari et al., 2016), cleaning and verification compulsions (Lewin et al., 2010; Matsunaga et al., 2002; Alonso et al., 2008), the chronicity of the disease and OCD family history (Catapano et al., 2010), somatic obsessions (Marazziti et al., 2002; De Berardis et al., 2015), including dysmorphic concerns, religious obsessions (Storch et al., 2014; Tolin et al., 2001) and the need for symmetry and accuracy (Matsunaga et al., 2002). Unfortunately, the existing studies have reached contradictory results (Eisen et al., 2001; Jacob et al., 2014; Marazziti et al., 2002). For example, better insight was directly linked to aggressive obsessions and “forbidden” thoughts (Alonso et al., 2008; Cherian et al., 2012), related more to contamination symptoms and less to ordering compulsions (Storch et al., 2014).
Pattern of occurrence of obsessive-compulsive symptoms in bipolar disorder
2021, Psychiatry ResearchCitation Excerpt :This result may be partly due to the narrow definition of OCS adopted. In fact, the inclusion of only fully egodystonic OCS may have underestimated the real prevalence of OCS (particularly of severe OCS) in our sample, since egosyntonic features are present in up to 36% of OCD patients (Catapano et al., 2010; Jacob et al., 2014) and are associated with higher OCS severity (Alonso et al., 2008; Jakubovski et al., 2011). Moreover, the cycling pattern of OCS severity in BD may lead clinicians to understate the high prevalence of OCS in specific single phases; in our study, for instance, 34.6% of the mixed patients and 20.9% of the depressive group had moderate-severe OCS.
Poor insight in obsessive-compulsive disorder: Examining the role of cognitive and metacognitive variables
2019, Journal of Obsessive-Compulsive and Related Disorders