title: Dimensional correlates of poor insight in obsessive-compulsive disorder.
abstract: BACKGROUND
  Cross-sectional studies have associated poor insight in patients with obsessive-compulsive disorder (OCD) with increased OCD symptom severity, earlier age of onset, comorbid depression, and treatment response. The goal of this current study was to examine the relationship between dimensions of OCD symptomatology and insight in a large clinical cohort of Brazilian patients with OCD. We hypothesized that poor insight would be associated with total symptom severity as well as with hoarding symptoms severity, specifically.
  
  
  METHODS
  824 outpatients underwent a detailed clinical assessment for OCD, including the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS), the Brown Assessment of Beliefs Scale (BABS), a socio-demographic questionnaire, and the Structured Clinical Interview for axis I DSM-IV disorders (SCID-P). Tobit regression models were used to examine the association between level of insight and clinical variables of interest.
  
  
  RESULTS
  Increased severity of current and worst-ever hoarding symptoms and higher rate of unemployment were associated with poor insight in OCD after controlling for current OCD severity, age and gender. Poor insight was also correlated with increased severity of current OCD symptoms.
  
  
  CONCLUSIONS
  Hoarding and overall OCD severity were significantly but weakly associated with level of insight in OCD patients. Further studies should examine insight as a moderator and mediator of treatment response in OCD in both behavioral therapy and pharmacological trials. Behavioral techniques aimed at enhancing insight may be potentially beneficial in OCD, especially among patients with hoarding.
authors.affiliation: Department of Psychology, University of Heidelberg, Germany.
authors.forename: Ewgeni
authors.initials: E
authors.lastname: Jakubovski
authors.forename: Christopher
authors.initials: C
authors.lastname: Pittenger
authors.forename: Albina Rodrigues
authors.initials: AR
authors.lastname: Torres
authors.forename: Leonardo Franklin
authors.initials: LF
authors.lastname: Fontenelle
authors.forename: Maria Conceicao
authors.initials: MC
authors.lastname: do Rosario
authors.forename: Ygor Arzeno
authors.initials: YA
authors.lastname: Ferrão
authors.forename: Maria Alice
authors.initials: MA
authors.lastname: de Mathis
authors.forename: Euripedes Constantino
authors.initials: EC
authors.lastname: Miguel
authors.forename: Michael H
authors.initials: MH
authors.lastname: Bloch
mesh_terms: D000328:Adult; D001938:Brazil; D015331:Cohort Studies; D003702:Delusions / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D000067836:Hoarding Disorder / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D010465:Perception; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult