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Related Experiment Videos

Obsessive-compulsive disorder with poor insight.

H Matsunaga1, N Kiriike, T Matsui

  • 1Department of Neuropsychiatry, Osaka City University Medical School, Osaka, Japan.

Comprehensive Psychiatry
|March 15, 2002
PubMed
Summary

Obsessive-compulsive disorder (OCD) with poor insight (PI) is a distinct subtype. Treatment improved insight and reduced OCD severity, but comorbid schizotypal personality disorder may indicate a worse prognosis.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Neuroscience

Background:

  • Obsessive-compulsive disorder (OCD) diagnosis includes a "poor insight" (PI) specifier, yet this subtype is understudied.
  • Understanding insight variations in OCD is crucial for effective treatment and prognosis.
  • Comorbidities, such as schizophrenia and personality disorders, can influence OCD presentation and outcomes.

Purpose of the Study:

  • To investigate the characteristics and treatment response of OCD patients with poor insight (PI).
  • To compare insight levels and functional impairment between OCD patients and those with schizophrenia and OCD (OCD+S).
  • To identify factors associated with persistent poor insight in OCD.

Main Methods:

  • Seventy-eight OCD patients were assessed for insight using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) insight question.

Related Experiment Videos

  • Patients were categorized into poor insight (PI) and good insight (GI) groups and compared with 20 OCD+S patients.
  • Insight, OCD severity, depressive symptoms, and comorbid personality disorders were reassessed after 6 months of treatment (clomipramine + cognitive-behavioral therapy).

    • Main Results:

    • At baseline, 36% of OCD patients had PI, showing similar functional impairment to OCD+S patients.
    • OCD patients were less likely to have PI compared to the OCD+S group.
    • After treatment, 56% of OCD PI patients improved, showing reduced OCD severity and depression; persistent PI was linked to higher rates of comorbid schizotypal personality disorder (SPD).

    Conclusions:

    • OCD patients exhibit a spectrum of insight, with PI associated with significant functional impairment.
    • Treatment, particularly a combination of clomipramine and cognitive-behavioral therapy, can improve insight in OCD PI patients.
    • Comorbid SPD in OCD PI patients may predict a poorer treatment prognosis and persistent poor insight.