University of South Florida School of Medicine, Rothman Center for Neuropsychiatry, Department of Pediatrics, St. Petersburg, FL, USA.
J Child Psychol Psychiatry. 2010 May;51(5):603-11. doi: 10.1111/j.1469-7610.2009.02181.x. Epub 2009 Dec 17.
Individuals with Obsessive-Compulsive Disorder (OCD) may lack insight into the irrational nature of their symptoms. Among adults with OCD, poor insight has been linked to greater symptom severity, increased likelihood of comorbid symptoms, lower adaptive functioning, and worse treatment outcomes. Parallel work regarding insight among children and adolescents, with OCD, is lacking. The aim of this research was to examine links between insight and demographic, cognitive, and clinical factors among youth with OCD.
Seventy-one youths with OCD (mean age = 11.7; 63% = male) were assessed as part of a larger treatment trial. Insight was measured via clinician interview.
Youth with low insight had poorer intellectual functioning and reported decreased perception of control over their environment. Additionally, youth with low insight were more likely to be younger, to report higher levels of depressive symptoms, and to report lower levels of adaptive functioning.
This set of cognitive, developmental and clinical factors that may predispose youth with OCD to have diminished insight. Data provide initial empirical support for diagnostic differences between youth and adults with regard to requiring intact insight. Implications for treatment are discussed.
强迫症(OCD)患者可能对其症状的不合理性质缺乏洞察力。在强迫症成年人中,洞察力差与症状严重程度增加、合并症状的可能性增加、适应功能降低以及治疗效果较差有关。关于儿童和青少年强迫症患者的洞察力方面的平行工作尚缺乏。本研究旨在检查强迫症青少年患者的洞察力与人口统计学、认知和临床因素之间的联系。
71 名强迫症青少年(平均年龄=11.7;63%=男性)作为更大的治疗试验的一部分进行了评估。洞察力通过临床医生访谈进行测量。
洞察力低的青少年的智力功能较差,并且报告对其环境的控制感降低。此外,洞察力较低的青少年更年轻,报告抑郁症状水平更高,报告适应功能水平更低。
这组认知、发展和临床因素可能使强迫症青少年更容易出现洞察力减弱。数据为青少年和成年人之间需要完整洞察力的诊断差异提供了初步的经验支持。讨论了对治疗的影响。