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Obsessive Compulsive Disorder with Poor Insight

Yıl 2014, Cilt: 6 Sayı: 2, 126 - 141, 06.11.2014
https://doi.org/10.5455/cap.20130816032746

Öz

Obsessive-compulsive disorder is a mental disorder that may cause severe disability. Insight in obsessive-compulsive disorder has been an issue of debate since the disorder was described for the first time. Formerly, obsessive-compulsive disorder was regarded as one of the neurotic disorders and patients were supposed to find their symptoms as totally senseless and exaggerated. However, the idea that obsessions have to be regarded egodystonic has changed recently. Firstly in the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV), the term "with poor insight" was used as a specifier for obsessive-compulsive disorder. Obsessive-compulsive disorder with low or no insight may differ from obsessive-compulsive disorder with good insight in terms of sociodemographic, clinical and treatment features. Along with types of obsessions, the levels of insight are subject to change. Obsessive-compulsive disorder with poor insight can either be a subtype with different features or a severe form of Obsessive-compulsive disorder. Along with DSM-5 insight in obsessive-compulsive disorder is no longer classified as absent or present. Insight in obsessive-compulsive disorder needs to be conceptualized as a spectrum or continuity.

Kaynakça

  • Kozak MJ, Foa EB. Obsessions, overvalued ideas, and delusions in obsessive-compulsive disorder. Behav Res Ther 1994; 32:343-353.
  • Bellino S, Patria L, Ziero S, Bogetto F. Clinical picture of obsessive-compulsive disorder with poor insight: a regression model. Psychiatry Res 2005; 136:223-231.
  • Foa EB, Kozak MJ, Goodman WK, Hollander E, Jenike MA, Rasmussen SA. DSM-IV field trial: obsessive-compulsive disorder. Am J Psychiatry 1995; 152:90-96.
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Arlington, VA, American Psychiatric Association, 1994.
  • Tükel R, Demet MM, Topçuoğlu V. Obsesif kompulsif bozukluğun fenomenolojisi. In Anksiyete Bozuklukları (Eds R Tükel, T Alkın):284-290. Ankara, Türkiye Psikiyatri Derneği Yayınları, 2006.
  • Eisen JL, Phillips KA, Baer L, Beer DA, Atala KD, Rasmussen SA. The Brown Assessment of Beliefs Scale: reliability and validity. Am J Psychiatry 1998; 155:102-108.
  • Özcan T, Kuru E, Şafak Y, Karadere ME, Yavuz KF, Turkçapar MH. Brown İnançların Değerlendirilmesi Ölçeği: geçerlik ve güvenirlik çalışması. Bilişsel Davranışçı Psikoterapi ve Araştırmalar Dergisi 2013; 2:25-33.
  • Neziroglu F, McKay D, Yaryura-Tobias JA, Stevens KP, Todaro J. The Overvalued Ideas Scale: development, reliability and validity in obsessive-compulsive disorder. Behav Res Ther 1999; 37:881-902.
  • Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL et al. The Yale-Brown Obsessive Compulsive Scale. I. development, use, and reliability. Arch Gen Psychiatry 1989; 46:1006-1011.
  • Beck AT, Baruch E, Balter JM, Steer RA, Warman DM. A new instrument for measuring insight: the Beck Cognitive Insight Scale. Schizophr Res 2004; 68:319-329.
  • Shimshoni Y, Reuven O, Dar R, Hermesh H. Insight in obsessive-compulsive disorder: a comparative study of insight measures in an Israeli clinical sample. J Behav Ther Exp Psychiatry 2011; 42:389-396.
  • Marazziti D, Dell'Osso L, Di Nasso E, Pfanner C, Presta S, Mungai F et al. Insight in obsessive-compulsive disorder: a study of an Italian sample. Eur Psychiatry 2002; 17:407-410.
  • Matsunaga H, Kiriike N, Matsui T, Oya K, Iwasaki Y, Koshimune K et al. Obsessive-compulsive disorder with poor insight. Compr Psychiatry 2002; 43:150-157.
  • Turksoy N, Tukel R, Ozdemir O, Karali A. Comparison of clinical characteristics in good and poor insight obsessivecompulsive disorder. J Anxiety Disord 2002; 16:413-423.
  • Elvish J, Simpson J, Ball LJ. Which clinical and demographic factors predict poor insight in individuals with obsessions and/or compulsions?. J of Anxiety Disord 2010; 24:231-237.
  • Catapano F, Perris F, Fabrazzo M, Cioffi V, Giacco D, De Santis V et al. Obsessive-compulsive disorder with poor insight: a three-year prospective study. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:323-330.
  • Cherian AV, Narayanaswamy JC, Srinivasaraju R, Viswanath B, Math SB, Kandavel T et al. Does insight have specific correlation with symptom dimensions in OCD? J Affect Disord 2012; 138:352-359.
  • Jakubovski E, Pittenger C, Torres AR, Fontenelle LF, do Rosario MC, Ferrão YA et al. Dimensional correlates of poor insight in obsessive–compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1677-1681.
  • De Berardis D, Campanella D, Gambi F, Sepede G, Salini G, Carano A et al. Insight and alexithymia in adult outpatients with obsessive–compulsive disorder. Eur Arch Psychiatry Clin Neurosci 2005; 255:350-358.
  • De Berardis D, Campanella D, Serront N, Gambi F, Carano A, La Rovere R et al. Insight and perceived expressed emotion among adult outpatients with obsessive-compulsive disorder. J Psychiatr Pract 2008; 14:154-159.
  • Poyurovsky M, Faragian S, Pashinian A, Heidrach L, Fuchs C, Weizman R et al. Clinical characteristics of schizotypal-related obsessive-compulsive disorder. Psychiatry Res 2008; 159:254-258.
  • Önen S, Karakaş Uğurlu G, Çayköylü A. The relationship between metacognitions and insight in obsessive–compulsive disorder. Compr Psychiatry 2013; 54:541-548.
  • Catapano F, Sperandeo R, Perris F, Lanzaro M, Maj M. Insight and resistance in patients with obsessive-compulsive disorder. Psychopathology 2001; 34:62-68.
  • Erzegovesi S, Cavallini MC, Cavedini P, Diaferia G, Locatelli M, Bellodi L. Clinical predictors of drug response in obsessivecompulsive disorder. J Clin Psychopharmacol 2001; 21:488-492.
  • Eisen JL, Rasmussen SA, Phillips KA, Price LH, Davidson J, Lydiard RB et al. Insight and treatment outcome in obsessivecompulsive disorder. Compr Psychiatry 2001; 42:494-497.
  • Ravi Kishore V, Samar R, Janardhan Reddy Y, Chandrasekhar C, Thennarasu K. Clinical characteristics and treatment response in poor and good insight obsessive–compulsive disorder. Eur Psychiatry 2004; 19:202-208.
  • Himle JA, Van Etten ML, Janeck AS, Fischer DJ. Insight as a predictor of treatment outcome in behavioral group treatment for obsessive–compulsive disorder. Cognit Ther Res 2006; 30:661-666.
  • Alonso P, Menchón JM, Segalàs C, Jaurrieta N, Jiménez-Murcia S, Cardoner N, et al. Clinical implications of insight assessment in obsessive-compulsive disorder. Compr Psychiatry 2008; 49:305-312.
  • Aigner M, Zitterl W, Prayer D, Demal U, Bach M, Prayer L et al. Magnetic resonance imaging in patients with obsessive– compulsive disorder with good versus poor insight. Psychiatry Res 2005;140:173-179.
  • Tumkaya S, Karadag F, Oguzhanoglu NK, Tekkanat C, Varma G, Ozdel O et al. Schizophrenia with obsessive-compulsive disorder and obsessive-compulsive disorder with poor insight: a neuropsychological comparison. Psychiatry Res 2009; 165:38-46.
  • Karadag F, Tumkaya S, Kırtaş D, Efe M, Alacam H, Oguzhanoglu NK. Neurological soft signs in obsessive compulsive disorder with good and poor insight. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1074-1079.
  • Kashyap H, Kumar J, Kandavel T, Reddy Y. Neuropsychological correlates of insight in obsessive–compulsive disorder. Acta Psychiatr Scand 2012; 126:106-114.
  • Jaafari N, Aouizerate B, Tignol J, El-Hage W, Wassouf I, Guehl D et al. The relationship between insight and uncertainty in obsessive-compulsive disorder. Psychopathology 2011; 44:272-276.
  • Gelegen V, Tamam L. Şizoobsesif bozukluk. Psikiyatride Güncel Yaklaşımlar 2013; 5:204-219.
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA, American Psychiatric Association, 2013.
  • Fontenelle LF, Mendlowicz MV, Soares ID, Versiani M. Patients with obsessive-compulsive disorder and hoarding symptoms: A distinctive clinical subtype? Compr Psychiatry 2004; 45:375-383.
  • Mataix-Cols D, Wooderson S, Lawrence N, Brammer MJ, Speckens A, Phillips ML. Distinct neural correlates of washing, checking, and hoarding symptom dimensions in obsessive-compulsive disorder. Arch Gen Psychiatry 2004; 61:564-576. Elvish J, Simpson J, Ball LJ. Which clinical and demographic factors predict poor insight in individuals with obsessions and/or compulsions? J Anxiety Disord 2010; 24:231-237. Serkut Bulut, Dr., Marmara Üniversitesi Tıp Fakültesi Psikiyatri ABD, İstanbul; Nurhan Fıstıkcı, Uzm.Dr., Bakırköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul; Volkan Topçuoğlu, Prof.Dr., Marmara Üniversitesi Tıp Fakültesi Psikiyatri ABD, İstanbul. Yazışma Adresi/Correspondence: Nurhan Fıstıkcı, Bakırköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul, Turkey. E-mail: nurhanfistikci@gmail.com Yazarlar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemiştir. The author reported no conflict of interest related to this article. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol6/no2/ Çevrimiçi yayım / Published online 29 Ağustos/August 29, 2013; doi: 10.5455/cap.20130816032746

İçgörüsü Az Olan Obsesif Kompulsif Bozukluk

Yıl 2014, Cilt: 6 Sayı: 2, 126 - 141, 06.11.2014
https://doi.org/10.5455/cap.20130816032746

Öz

Obsesif 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.

Kaynakça

  • Kozak MJ, Foa EB. Obsessions, overvalued ideas, and delusions in obsessive-compulsive disorder. Behav Res Ther 1994; 32:343-353.
  • Bellino S, Patria L, Ziero S, Bogetto F. Clinical picture of obsessive-compulsive disorder with poor insight: a regression model. Psychiatry Res 2005; 136:223-231.
  • Foa EB, Kozak MJ, Goodman WK, Hollander E, Jenike MA, Rasmussen SA. DSM-IV field trial: obsessive-compulsive disorder. Am J Psychiatry 1995; 152:90-96.
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Arlington, VA, American Psychiatric Association, 1994.
  • Tükel R, Demet MM, Topçuoğlu V. Obsesif kompulsif bozukluğun fenomenolojisi. In Anksiyete Bozuklukları (Eds R Tükel, T Alkın):284-290. Ankara, Türkiye Psikiyatri Derneği Yayınları, 2006.
  • Eisen JL, Phillips KA, Baer L, Beer DA, Atala KD, Rasmussen SA. The Brown Assessment of Beliefs Scale: reliability and validity. Am J Psychiatry 1998; 155:102-108.
  • Özcan T, Kuru E, Şafak Y, Karadere ME, Yavuz KF, Turkçapar MH. Brown İnançların Değerlendirilmesi Ölçeği: geçerlik ve güvenirlik çalışması. Bilişsel Davranışçı Psikoterapi ve Araştırmalar Dergisi 2013; 2:25-33.
  • Neziroglu F, McKay D, Yaryura-Tobias JA, Stevens KP, Todaro J. The Overvalued Ideas Scale: development, reliability and validity in obsessive-compulsive disorder. Behav Res Ther 1999; 37:881-902.
  • Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL et al. The Yale-Brown Obsessive Compulsive Scale. I. development, use, and reliability. Arch Gen Psychiatry 1989; 46:1006-1011.
  • Beck AT, Baruch E, Balter JM, Steer RA, Warman DM. A new instrument for measuring insight: the Beck Cognitive Insight Scale. Schizophr Res 2004; 68:319-329.
  • Shimshoni Y, Reuven O, Dar R, Hermesh H. Insight in obsessive-compulsive disorder: a comparative study of insight measures in an Israeli clinical sample. J Behav Ther Exp Psychiatry 2011; 42:389-396.
  • Marazziti D, Dell'Osso L, Di Nasso E, Pfanner C, Presta S, Mungai F et al. Insight in obsessive-compulsive disorder: a study of an Italian sample. Eur Psychiatry 2002; 17:407-410.
  • Matsunaga H, Kiriike N, Matsui T, Oya K, Iwasaki Y, Koshimune K et al. Obsessive-compulsive disorder with poor insight. Compr Psychiatry 2002; 43:150-157.
  • Turksoy N, Tukel R, Ozdemir O, Karali A. Comparison of clinical characteristics in good and poor insight obsessivecompulsive disorder. J Anxiety Disord 2002; 16:413-423.
  • Elvish J, Simpson J, Ball LJ. Which clinical and demographic factors predict poor insight in individuals with obsessions and/or compulsions?. J of Anxiety Disord 2010; 24:231-237.
  • Catapano F, Perris F, Fabrazzo M, Cioffi V, Giacco D, De Santis V et al. Obsessive-compulsive disorder with poor insight: a three-year prospective study. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:323-330.
  • Cherian AV, Narayanaswamy JC, Srinivasaraju R, Viswanath B, Math SB, Kandavel T et al. Does insight have specific correlation with symptom dimensions in OCD? J Affect Disord 2012; 138:352-359.
  • Jakubovski E, Pittenger C, Torres AR, Fontenelle LF, do Rosario MC, Ferrão YA et al. Dimensional correlates of poor insight in obsessive–compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1677-1681.
  • De Berardis D, Campanella D, Gambi F, Sepede G, Salini G, Carano A et al. Insight and alexithymia in adult outpatients with obsessive–compulsive disorder. Eur Arch Psychiatry Clin Neurosci 2005; 255:350-358.
  • De Berardis D, Campanella D, Serront N, Gambi F, Carano A, La Rovere R et al. Insight and perceived expressed emotion among adult outpatients with obsessive-compulsive disorder. J Psychiatr Pract 2008; 14:154-159.
  • Poyurovsky M, Faragian S, Pashinian A, Heidrach L, Fuchs C, Weizman R et al. Clinical characteristics of schizotypal-related obsessive-compulsive disorder. Psychiatry Res 2008; 159:254-258.
  • Önen S, Karakaş Uğurlu G, Çayköylü A. The relationship between metacognitions and insight in obsessive–compulsive disorder. Compr Psychiatry 2013; 54:541-548.
  • Catapano F, Sperandeo R, Perris F, Lanzaro M, Maj M. Insight and resistance in patients with obsessive-compulsive disorder. Psychopathology 2001; 34:62-68.
  • Erzegovesi S, Cavallini MC, Cavedini P, Diaferia G, Locatelli M, Bellodi L. Clinical predictors of drug response in obsessivecompulsive disorder. J Clin Psychopharmacol 2001; 21:488-492.
  • Eisen JL, Rasmussen SA, Phillips KA, Price LH, Davidson J, Lydiard RB et al. Insight and treatment outcome in obsessivecompulsive disorder. Compr Psychiatry 2001; 42:494-497.
  • Ravi Kishore V, Samar R, Janardhan Reddy Y, Chandrasekhar C, Thennarasu K. Clinical characteristics and treatment response in poor and good insight obsessive–compulsive disorder. Eur Psychiatry 2004; 19:202-208.
  • Himle JA, Van Etten ML, Janeck AS, Fischer DJ. Insight as a predictor of treatment outcome in behavioral group treatment for obsessive–compulsive disorder. Cognit Ther Res 2006; 30:661-666.
  • Alonso P, Menchón JM, Segalàs C, Jaurrieta N, Jiménez-Murcia S, Cardoner N, et al. Clinical implications of insight assessment in obsessive-compulsive disorder. Compr Psychiatry 2008; 49:305-312.
  • Aigner M, Zitterl W, Prayer D, Demal U, Bach M, Prayer L et al. Magnetic resonance imaging in patients with obsessive– compulsive disorder with good versus poor insight. Psychiatry Res 2005;140:173-179.
  • Tumkaya S, Karadag F, Oguzhanoglu NK, Tekkanat C, Varma G, Ozdel O et al. Schizophrenia with obsessive-compulsive disorder and obsessive-compulsive disorder with poor insight: a neuropsychological comparison. Psychiatry Res 2009; 165:38-46.
  • Karadag F, Tumkaya S, Kırtaş D, Efe M, Alacam H, Oguzhanoglu NK. Neurological soft signs in obsessive compulsive disorder with good and poor insight. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1074-1079.
  • Kashyap H, Kumar J, Kandavel T, Reddy Y. Neuropsychological correlates of insight in obsessive–compulsive disorder. Acta Psychiatr Scand 2012; 126:106-114.
  • Jaafari N, Aouizerate B, Tignol J, El-Hage W, Wassouf I, Guehl D et al. The relationship between insight and uncertainty in obsessive-compulsive disorder. Psychopathology 2011; 44:272-276.
  • Gelegen V, Tamam L. Şizoobsesif bozukluk. Psikiyatride Güncel Yaklaşımlar 2013; 5:204-219.
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA, American Psychiatric Association, 2013.
  • Fontenelle LF, Mendlowicz MV, Soares ID, Versiani M. Patients with obsessive-compulsive disorder and hoarding symptoms: A distinctive clinical subtype? Compr Psychiatry 2004; 45:375-383.
  • Mataix-Cols D, Wooderson S, Lawrence N, Brammer MJ, Speckens A, Phillips ML. Distinct neural correlates of washing, checking, and hoarding symptom dimensions in obsessive-compulsive disorder. Arch Gen Psychiatry 2004; 61:564-576. Elvish J, Simpson J, Ball LJ. Which clinical and demographic factors predict poor insight in individuals with obsessions and/or compulsions? J Anxiety Disord 2010; 24:231-237. Serkut Bulut, Dr., Marmara Üniversitesi Tıp Fakültesi Psikiyatri ABD, İstanbul; Nurhan Fıstıkcı, Uzm.Dr., Bakırköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul; Volkan Topçuoğlu, Prof.Dr., Marmara Üniversitesi Tıp Fakültesi Psikiyatri ABD, İstanbul. Yazışma Adresi/Correspondence: Nurhan Fıstıkcı, Bakırköy Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, İstanbul, Turkey. E-mail: nurhanfistikci@gmail.com Yazarlar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemiştir. The author reported no conflict of interest related to this article. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol6/no2/ Çevrimiçi yayım / Published online 29 Ağustos/August 29, 2013; doi: 10.5455/cap.20130816032746
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Derleme
Yazarlar

Serkut Bulut Bu kişi benim

Nurhan Fıstıkcı Bu kişi benim

Volkan Topçuoğlu Bu kişi benim

Yayımlanma Tarihi 6 Kasım 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 6 Sayı: 2

Kaynak Göster

AMA Bulut S, Fıstıkcı N, Topçuoğlu V. İçgörüsü Az Olan Obsesif Kompulsif Bozukluk. Psikiyatride Güncel Yaklaşımlar. Haziran 2014;6(2):126-141. doi:10.5455/cap.20130816032746

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