Association between obsession, compulsion, depression and insight in obsessive-compulsive disorder: a meta-analysis

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Previous research on insight's relationship with symptom severity in obsessive-compulsive disorder (OCD) yielded inconsistent findings.
• This study investigated clinical differences and treatment changes between adult OCD patients with poor insight (OCD-PI) and good insight (OCD-GI).

Purpose of the Study:

• To compare obsessive-compulsive (O-C) and depressive symptom severity in OCD patients with poor versus good insight.
• To analyze treatment-related changes in these symptoms based on insight levels.
• To identify insight impairment as a potential core deficit in OCD.

Main Methods:

• A meta-analysis was conducted, screening 59 full-text articles.
• Twenty studies were included in the final meta-analysis.
• Meta-regression was used to explore factors influencing inter-group differences.

Main Results:

• Patients with OCD-PI exhibited significantly higher O-C symptom severity (p < 0.001, g > 0.7) and depressive symptom severity (p < 0.001, g = 0.614) compared to OCD-GI.
• Insight showed significant moderate correlations with treatment outcomes for both O-C symptoms (r = 0.33) and depressive symptoms (r = 0.47).
• Methodological factors were found to influence the magnitude of O-C symptom differences between groups.

Conclusions:

• Poorer insight in OCD is associated with increased symptom severity (both O-C and depressive).
• Impaired insight correlates with less symptom improvement following treatment.
• Insight impairment may represent a critical, core deficit within the OCD spectrum.