The Many Faces of Guilt: A Review Mapping Unique and Overlapping Expressions in OCD and Depression

Guilt, a complex emotional experience pervading many lives, takes on an intricate form when intertwined with psychiatric conditions. As a multifaceted concept, guilt represents a key diagnostic feature in depression and is an integral part of obsessive compulsive disorder (OCD). This systematic review aimed to synthesize empirical research on the varied dimensions of guilt across these two mental illnesses, where guilt is emphasized as a pathognomonic factor.

A systematic computer-based literature search was conducted, using a rigorous set of eligibility criteria and specific keyword combinations to ensure relevant and exhaustive coverage of the topic. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a comprehensive literature search spanning multiple databases identified 12 eligible studies on guilt in OCD and 8 in depression. The findings revealed 20 distinct guilt constructs measured across the two disorders. Notably, 5 unique guilt subtypes and 15 themes for OCD and 6 exclusively studied guilt for depression emerged, reflecting potential disorder-specific manifestations of guilt.

Delineating such guilt profiles holds the potential to untangle the role of guilt in the onset, perpetuation, and clinical course of OCD and depression. This comprehensive mapping of guilt constructs provides an empirical foundation for elucidating disorder-specific pathways influenced by guilt, thereby informing the development of targeted psychological interventions tailored to the distinct guilt patterns underpinning these debilitating conditions.