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Correlates of insight into different symptom dimensions in obsessive-compulsive disorder

Júlia M. Fontenelle, PhD

Anxiety and Depression Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

Ben J. Harrison, PhD

Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Victoria, Australia

Lívia  Santana, PhD

Anxiety and Depression Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

Maria Conceição  do Rosário, MD, PhD

Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil

Marcio  Versiani, MD, PhD

Anxiety and Depression Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

Leonardo F. Fontenelle, MD, PhD

Anxiety and Depression Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Department of Psychiatry and Mental Health, Institute of Community Health, Fluminense Federal University, D’Or Institute for Research and Education, Rio de Janeiro, Brazil

BACKGROUND: In this study, we evaluated insight into different obsessive-compulsive disorder (OCD) symptom dimensions and their impact on clinical and sociodemographic features of patients with OCD.

METHODS: Sixty OCD patients were assessed with the Brown Assessment of Beliefs Scale (BABS), the Dimensional Yale-Brown Obsessive-Compulsive Scale–Short Version, the Beck Depression Inventory, and the Sheehan Disability Scale. Two methods of using BABS were employed: 1) a traditional approach, which considers a composite of the insight into existing OCD symptoms, and 2) an alternative approach, which includes assessments of insight into each OCD symptom dimension separately.

RESULTS: Composite BABS scores correlated with global severity of OCD and depressive symptoms, and degree of interference on social life/leisure activities and family life/home responsibilities. Dimension-specific correlations between severity of symptoms and insight ranged from very high (P = .87, for hoarding) to moderate (P = .61, for miscellaneous symptoms). Greater severity of depression and concomitant generalized anxiety disorder were independently associated with lower levels of insight into aggressive/checking symptoms. While earlier-onset OCD was associated with lower insight into sexual/religious and symmetry symptoms, later-onset OCD displayed lower insight into hoarding.

CONCLUSIONS: Assessing insight into dimension-specific OCD symptoms may challenge the existence of clear-cut OCD with fair or poor insight.

KEYWORDS: obsessive-compulsive disorder, obsessions, hoarding, awareness, psychopathology

ANNALS OF CLINICAL PSYCHIATRY 2013;25(1):11-16

CORRESPONDENCE: Leonardo F. Fontenelle, MD, PhD, Rua Visconde de Pirajá, 547 Sala 719, Ipanema, Rio de Janeiro 22410-003, Brazil E-MAIL: lfontenelle@gmail.com
Annals of Clinical Psychiatry ©2013 Quadrant HealthCom Inc.

 
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