Insight in pediatric obsessive-compulsive disorder: associations with clinical presentation.
Insight has emerged as a significant treatment outcome predictor in adult obsessive-compulsive disorder (OCD), with some suggesting that OCD with poor insight represents a distinct clinical subtype. Despite its clinical relevance, limited data exist on insight in pediatric OCD patients. The present study investigated the relation between poor insight and clinical characteristics among children and adolescents with OCD (N=78, ages 6-20 years). Forty-five percent of the sample (n=35) was considered to have low levels of insight into their symptoms, as determined by clinician rating on item 11 of the Children's Yale-Brown Obsessive-Compulsive Scale. Pearson product-moment correlations showed a significant, inverse relation between insight and OCD severity. Relative to the high insight group, parents of patients with low insight reported higher levels of OCD-related impairment and family accommodation. These findings suggest that OCD with poor insight may represent a distinct clinical feature that may require more intensive and multimodal treatment approaches.
Storch
Eric A
EA
Department of Psychiatry, University of Florida, Gainesville, FL, USA. estorch@psychiatry.ufl.edu
Milsom
Vanessa A
VA
Merlo
Lisa J
LJ
Larson
Michael
M
Geffken
Gary R
GR
Jacob
Marni L
ML
Murphy
Tanya K
TK
Goodman
Wayne K
WK
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D001364:Awareness; D002648:Child; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D005192:Family Health; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D017063:Outcome Assessment, Health Care; D010290:Parents / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires