Are Mentalizing Abilities and Insight Related to the Severity of Obsessive-Compulsive Disorder

Abstract

ObjectiveThe aim of this study is to investigate whether insight and mentalizing abilities are related to the severity of Obsessive Compulsive Disorder (OCD) in treatment resistant OCD. We look at the association between treatment resistance, insight, and mentalizing ability. MethodsThe study was conducted with 71 OCD patients; 30 of them met the criteria for treatment resistant OCD, whereas the other 41 (57.7%) were labeled as responder group. All patients were assessed with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Reading the Mind in the Eyes Test (RMET), Brown Assessment of Beliefs Scale (BABS), Mini International Neuropsychiatric Interview, Beck Depression Inventory, and Beck Anxiety Inventory.ResultsThe resistant group received higher depression and anxiety mean scores and had significantly longer illness duration. The RMET score was significantly higher for responders. The Y-BOCS insight score and the BABS score were significantly higher for the resistant group. BABS scores were negatively correlated with RMET total scores. RMET scores were found to be significant predictor of insight even when other potential factors were controlled for.ConclusionResults suggest that better mentalizing abilities may be a predictor of better treatment outcome in patients with OCD.

Social Cognition and Obsessive-Compulsive Disorder: A Review of Subdomains of Social Functioning

“…However, ToM deficits in OCD do not seem to be explained by more general cognitive deficits alone (73,76), highlighting the importance of investigating social cognition in the disorder as a separate construct. While most studies do not indicate a significant relation between ToM and symptom severity (47,76,78,79), level of illness insight of patients does appear to be an important moderator of ToM deficits (73,75,80). Poor insight in OCD is associated with several clinical characteristics, such as higher comorbidity rates, specifically depression and schizophrenia spectrum disorders, poorer treatment response, more severe symptoms, and longer illness duration (92,93).…”

“…An important target for future studies is therefore to unravel which characteristics of patients are associated with poorer social cognitive functioning. A promising factor in this respect is level of illness insight of patients, as several studies show deficient ToM abilities only in those with less insight (73,75,80). However, the role of factors related to poor insight, such as increased comorbidity with schizophrenia, or poorer overall cognitive, emotional or intellectual functioning, needs to be investigated as well.…”

“…Yet, other patient studies did not demonstrate significant relations between symptom severity and ToM (47,76,78,79). There is however evidence to suggest that the extent to which patients are aware of the irrationality of their obsessions and/or compulsions, i.e., their level of insight, is related to ToM abilities (73,75,80). Tulacı et al (80) found significant negative correlations between insight level and all ToM tasks, with ToM performance significantly lower in patients with poor compared to good insight.…”

MRI-Based Multimodal Approach to the Assessment of Clinical Symptom Severity of Obsessive-Compulsive Disorder

“…Obsessive-compulsive disorder (OCD) is a common psychiatric disorder characterized by intrusive thoughts, repetitive acts and/or compulsive behaviors with a lifetime prevalence of 2.3% [ 1 , 2 ]. Especially, OCD behaviors involve the cognitive dysfunction and poor memory.…”

A critical review of cognitive behavioural therapy for hoarding disorder: How can we improve outcomes?

“…Recent research suggests that enhancing one's mentalizing abilities may largely improve treatment outcomes for disorders involving lack of insight (Konstantakopoulos, 2019). For instance, better mentalizing ability was the strongest predictor of improved insight among individuals in a clinical OCD sample (İnanç & Altıntaş, 2018). Evidence shows that mentalization‐based treatment reduces interpersonal problems and improves emotion regulation (Griffiths et al, 2019; Hayden et al, 2018).…”