Insight And Its Clinical Correlations In Patients With Obsessive-Compulsive Disorder

[OBJECTIVE] To explore the insight in patients with obsessive -compulsive disorder(OCD), and analyze the factors that affect the insight and clinical features of OCD patients with poor insight.[METHODS] Sixty-eight patients with OCD were sampled from psychological clinic of Shandong Mental Health Center. All patients were met with DSM-IV criteria for OCD .The insight of all patients is assessed by item 11 of Y-BOCS, and the clinical features of all patients were evaluated by general conditions scale, OCD symptom checklist, Y-BOCS, HAMD, HAMA, BPRS. Then the possible influencing factors on insight were explored by correlation analysis and multiple factors analysis. Finally all the patients were divided into two groups, the good insight group (<3 scores) and the poor insight group (≥3 scores) , according to the scores of the item 11 of Y-BOCS in order to compare the clinical features of them.[RESULTS]1. According to the scores of the item 11 of Y-BOCS, of all sixty-eight patients, six(8. 8%) patients had a score of 0, eight(11.8%) patients had a score of 1, twenty-three(33.8%) patients had a scare of 2, twenty-four (35. 3 %) patients had a score of 3, seven(10. 3%) patients had a score of 4. Average score was 2. 25±1. 098. There were thirty-seven(54. 4%) patients in the good insight group(<3). There were thirty-one (45.6%) patients in the poor insight group(≥3).2.Pearson' s correlation analysis revealed that insight were positively related to HAMD total scores, Y-BOCS for avoidance scores, the compulsion' s hindrance to normal function, Y-BOCS for extensive slowness scores , the pain caused by compulsion, the time spent on compulsion, the obsession' s hindrance to normal function, the time spent on obsession, the effect of patients' resistance to obsession, HAMD for cognitive disturbance scores, compulsion total scores, BPRS for hostile-suspiciousness scores, patients' active resistance to compulsion, BPRS for thought disturbance scores, the effect of patients' resistance to compulsion, obsession total scores, the patients' active resistance to obsession, obsession and compulsion total scores, Y-BOCS for total severity scores, BPRS total scores (r=0.253～0.705, p<0.05).Spearman correlation analysis revealed that insight was positively related to impulses (r=0.328, p<0.05), while it was negatively related to the education level and religious obsession(r=-0.309, -0.303 , p<0.05).Multiple stepwise regression analysis revealed that at the a=0.05 levels, factors that were chosen into the equation in order included BPRS total scores, the patients' active resistance to obsession, the effect of the patients' resistance to compulsion and impulses(r=0.172 ～ 0.547, p<0.05).3.For the BPRS for activation scores, HAMD for weight scores, HAMD for retardation scores, HAMA total scores, HAMA for somatic anxiety scores, HAMD for anxiety/somatization scores, BPRS for hostile-suspiciousness scores, compulsion total scores, HAMD total scores, BPRS for thought disturbance scores, HAMD for cognitive disturbance scores, obsession scores, obsession and compulsion scores, Y-BOCS for total severity scores, BPRS total scores, they were all higher in the poor insight group (t=2.044～6.895, p<0.05) .Religious obsession and images were more frequent in the poor insight group ( x~2 = 5.073, 3.896, p<0.05) . [CONCLUSIONS]1. The insight of OCD patients is not all complete, and there exists some patients who can be said to have shown poor insight, about covering 45. 6%.2. The insight of OCD patients is affected by many factors which included the severity of OCD symptoms, the patients' psychotic symptoms, the patients' education level and the type of OCD symptoms (such as religious obsession and impulses).3. Compared with good insight OCD, poor insight OCD has its own clinical features. The symptoms of OCD, anxiety, depression and psychosis are heavier. The Occurrence rate of religious obsession and images are much higher.