Clinical picture of obsessive-compulsive disorder with poor insight: A regression model

Bellino, Silvio; Patria, Luca; Ziero, Simona; Bogetto, Filippo

doi:10.1016/j.psychres.2004.04.015

Cited by 83 publications

(78 citation statements)

References 29 publications

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“…It is highly plausible that an individual is less likely to attempt to resist a compulsion if he or she believes that the execution of the compulsion is vital to prevent a catastrophe (indicating poor insight). Bellino et al (Bellino et al, 2005) found a specific inverse correlation between insight in OCS and the severity of compulsive symptoms. Other studies found an association between lower insight and higher levels of OCS, but this was not limited to the severity of compulsions (Catapano et al, 2001;Turksoy et al, 2002).…”

Section: Discussionmentioning

confidence: 97%

Factor structure of the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) in a large sample of patients with schizophrenia or related disorders and comorbid obsessive–compulsive symptoms

Boyette

Swets

Meijer

et al. 2011

Psychiatry Research

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a b s t r a c t a r t i c l e i n f oIn the past decade there has been an increasing interest in the levels of obsessive-compulsive symptoms (OCS) found in patients with schizophrenia or related disorders. The widely acknowledged gold standard measure of the severity of OCS is the content-free version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) (Goodman et al., 1989a,b). However, factor analytic research in patients with obsessive-compulsive disorder (OCD) provided varied results. So far no study has been conducted on the factor structure of the Y-BOCS in patients with schizophrenia. The present study addresses this issue. We administered the Y-BOCS in a sample of 217 patients with schizophrenia or related disorders and comorbid OCS who participated in a multicentre cohort study. We used principal component analysis (PCA) to explore the underlying factor structure. A two-factor solution consistent with the originally proposed scoring structure of the Y-BOCS provided the optimal fit. We also found some support for a three-factor solution consistent with earlier findings by Kim et al. and Moritz et al. (Kim et al., 1994;Moritz et al., 2002). The produced factors showed good reliability and strong correlations with the Y-BOCS Total score. However, the resistance to compulsion item failed to demonstrate adequate correlation to the Total score, a finding consistent with earlier findings in several studies with patients with OCD.

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Section: Discussionmentioning

confidence: 97%

Factor structure of the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) in a large sample of patients with schizophrenia or related disorders and comorbid obsessive–compulsive symptoms

Boyette

Swets

Meijer

et al. 2011

Psychiatry Research

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“…Subsequent to a randomized, double-blind, placebo-controlled trial in 1986, the first-generation antipsychotic trifluoperazine was given FDA approval for short-term treatment of generalized non-psychotic anxiety (Gao, Muzina, Gajwani & Calabrese, 2006). Specifically, antipsychotics may be beneficial in OCD, which many have noted shares some features of a psychotic or delusional process (Bellino, Patria, Ziero & Bogetto, 2005;Kozak & Foa, 1994;Rodowski, Cagande & Riddle, 2008). Patients with OCD have classically had insight into the illogical nature of their thoughts or behaviors; the criteria for OCD in the current version of the Diagnostic and Statistical Manual of Mental Disorders includes that the patient recognizes the obsessions or compulsions are excessive or unreasonable, although this does not apply to children (DSM-IV-TR; APA, 2000).…”

Section: Risperidonementioning

confidence: 99%

“…The question, then, is if these fixed, false beliefs qualify merely as obsessive thoughts, over-valued ideas, or are in fact, delusion (Kozak & Foa, 1994). Studies of these "atypical obsessive-compulsives" indicate that these patients are qualitatively different from patients with classical, insightful OCD, with increased symptom severity, earlier onset of symptoms, and greater likelihood to be refractory to treatment (Bellino et al, 2005;Kozak & Foa, 1994). Since Amy is a child, the DSM qualifier of requiring insight does not apply to making the diagnosis of OCD, yet the comparisons to a psychotic process remain.…”

Section: Risperidonementioning

confidence: 99%

A case of severe adolescent obsessive-compulsive disorder treated with inpatient hospitalization, risperidone and sertraline

Nguyen¹,

Shapiro²,

Welch³

2012

Journal of Behavioral Addictions

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Background:The initial treatment of obsessive-compulsive disorder (OCD) has generally been limited to serotonergic agents, cognitive-behavioral therapy (CBT), or a combination of the two. These findings were supported by the POTS study for OCD in children and adolescents. However, treatment with serotonergic agents or CBT can take several weeks before benefit is seen; severe cases of OCD may require more immediate treatment. Case report: The authors present a case of severe OCD in an adolescent that required immediate treatment due to her critical medical condition. The patient's symptoms included not eating or taking medications or fluids by mouth due to fears of contamination. A medical hospitalization was previously required due to dehydration. As treatment with an SSRI would not have quick enough onset and the patient was initially resistant to participating in CBT, the patient was psychiatrically hospitalized and first started on liquid risperidone. After several doses of risperidone, the patient was able to participate in CBT and start sertraline. Discussion: The authors discuss the differential diagnosis of such a patient, including the continuum of OCD symptoms and psychotic symptoms. The authors discuss the different treatment options, including the utilization of inpatient psychiatric hospitalization. The authors discuss the potential risks and benefits of using atypical antipsychotics in lieu of benzodiazepines for the initial treatment of severe adolescent OCD. The authors also discuss other current treatment recommendations and rationale for the treatment that was pursued. Conclusions: This patient received benefit of her symptoms relatively quickly with psychiatric hospitalization and an atypical antipsychotic. The diagnosis of a psychotic disorder should be considered. These treatment options must be weighed against the risks of atypical antipsychotics, including extrapyramidal symptoms, weight gain, and metabolic syndrome; benzodiazepines also have their risks and benefits. Additionally, the cost of time and finances of inpatient hospitalization must be considered. More research is needed regarding the short-and long-term efficacy and safety of antipsychotics in the treatment of OCD in the child and adolescent population.

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“…Lewis 1936'da şu sonuca varmıştır: "Obsesyonların anlamsızlığını ve saçma olduklarını kabul etmek bu hastalığın her zaman temel bir özelliği değildir". [2] Sonraki yıllarda da benzer gözlemler devam etmiş ve farklı yazarlar böyle hastalara "obsesif psikotikler" ya da "psikotik özellikleri olan OKB hastaları" adını vermişlerdir. [2] DSM-IV alan çalışmasının hedefi OKB hastalarının belirtilerini aşırı ya da anlamsız buldukları şeklindeki genel görüşün araştırılmasıdır.…”

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“…[2] Sonraki yıllarda da benzer gözlemler devam etmiş ve farklı yazarlar böyle hastalara "obsesif psikotikler" ya da "psikotik özellikleri olan OKB hastaları" adını vermişlerdir. [2] DSM-IV alan çalışmasının hedefi OKB hastalarının belirtilerini aşırı ya da anlamsız buldukları şeklindeki genel görüşün araştırılmasıdır. [3] Çalışmada 5 maddelik İnançların Sabitliği Ölçeği kullanılmıştır.…”

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Obsessive Compulsive Disorder with Poor Insight

Bulut¹,

Fıstikçı²,

Topçuoğlu³

2014

Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychia

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ÖzetObsesif kompulsif bozukluk ileri derecede yeti yitimine neden olabilen ruhsal bir bozukluktur. OKB hastalarında içgörü hastalığın ilk tanımlanmasından bu yana tartışma konusudur. Önceleri, nörotik bozukluklardan biri olarak kabul edilen obsesif kompulsif bozuklukta hastaların belirtilerini tamamen saçma ve abartılı bulmaları gerektiği düşünülmüştür. Ancak, obsesyonların ve kompulsiyonların her zaman egodistonik bulunacağı fikri giderek değişmiştir. İlk olarak Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabının 4. Baskısında (DSM-IV)'te obsesif kompulsif bozuklukta "içgörüsü az olan" ifadesine yer verilmiştir. İçgörüsü az olan ya da olmayan obsesif kompulsif bozukluğun içgörünün korunduğu obsesif kompulsif bozukluktan sosyodemografik, klinik ve tedavi özellikleri bakımından farklılıkları olabilir. Obsesif kompulsif bozuklukta belirti tiplerine göre içgörü düzeyleri değişebilmektedir. İçgörüsü az obsesif kompulsif bozukluk, obsesif kompulsif bozukluğun şiddetli bir formu ya da farklı özellikler gösteren bir alt tip olabilir. DSM-5 ile birlikte içgörü belirteci sınıflan-dırmadan çıkarılmıştır. Obsesif kompulsif bozukluk hastalarının içgörülerinin bir yelpaze ya da süreklilik şeklinde ele alınması gerekir.Anahtar sözcükler: Obsesif kompulsif bozukluk, içgörü, sınıflandırma. AbstractObsessive-compulsive disorder

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Clinical picture of obsessive-compulsive disorder with poor insight: A regression model

Cited by 83 publications

References 29 publications

Factor structure of the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) in a large sample of patients with schizophrenia or related disorders and comorbid obsessive–compulsive symptoms

Factor structure of the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) in a large sample of patients with schizophrenia or related disorders and comorbid obsessive–compulsive symptoms

A case of severe adolescent obsessive-compulsive disorder treated with inpatient hospitalization, risperidone and sertraline

Obsessive Compulsive Disorder with Poor Insight

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