Alonso Pino, Menchón José M, Segalàs Cinto, Jaurrieta Nuria, Jiménez-Murcia Susana, Cardoner Narcís, Labad Javier, Real Eva, Pertusa Alberto, Vallejo Julio
OCD Clinical and Research Unit, Psychiatry Department, Bellvitge Hospital, Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, Spain.
Compr Psychiatry. 2008 May-Jun;49(3):305-12. doi: 10.1016/j.comppsych.2007.09.005. Epub 2007 Dec 21.
Poor insight has been reported in 15% to 36% of patients with obsessive-compulsive disorder (OCD), but little is known about its clinical correlations. This study examines insight among patients with OCD using a standardized instrument, the Brown Assessment of Beliefs Scale, and analyzes its relationship with clinical factors. Insight was assessed in 132 patients with OCD, before and after pharmacologic treatment, using the Brown Assessment of Beliefs Scale. Differences between patients with good and poor insight on sociodemographic variables, OCD severity, comorbidity, and treatment response were studied. Stability of insight after pharmacologic treatment was also examined. Thirty-nine patients (29.5%) exhibited poor insight. They showed more depressive symptoms (P = .001) and personality disorders (P = .001), especially the schizotypal form, than did good insight subjects, but there were no significant differences in treatment response. Insight significantly improves after treatment (P < .001). Our results suggest that insight in OCD varies widely and constitutes a dynamic phenomenon that can improve after treatment and is influenced by clinical conditions such as affective status or personality.
据报道，15%至36%的强迫症（OCD）患者存在自知力差的情况，但对其临床相关性却知之甚少。本研究使用标准化工具——布朗信念评估量表，对强迫症患者的自知力进行了研究，并分析了其与临床因素的关系。使用布朗信念评估量表，在132例强迫症患者药物治疗前后对其自知力进行了评估。研究了自知力良好和自知力差的患者在社会人口统计学变量、强迫症严重程度、合并症及治疗反应方面的差异。还考察了药物治疗后自知力的稳定性。39例患者（29.5%）自知力差。与自知力良好的患者相比，他们表现出更多的抑郁症状（P = .001）和人格障碍（P = .001），尤其是分裂型人格障碍，但在治疗反应方面没有显著差异。治疗后自知力显著改善（P < .001）。我们的结果表明，强迫症患者的自知力差异很大，是一种动态现象，治疗后可改善，且受情感状态或人格等临床状况的影响。
