Tulacı Rıza Gökçer, Cankurtaran Eylem Şahin, Özdel Kadir, Öztürk Nefise, Kuru Erkan, Özdemir İlker
a Department of Psychiatry , Uşak University Teaching and Research Hospital , Uşak , Turkey.
b Department of Psychiatry , Güven Hospital , Ankara , Turkey.
Nord J Psychiatry. 2018 May;72(4):273-280. doi: 10.1080/08039488.2018.1436724. Epub 2018 Feb 9.
It is known that obsessive-compulsive disorder (OCD) patients with poor insight display more severe neuropsychological impairments than other patients with OCD. There are limited studies of OCD and theory of mind (ToM).
To investigate ToM skills in patients with OCD and the relationship between insight and ToM skills by comparing OCD patients with good and poor insight.
Eighty patients with OCD and 80 healthy controls completed the structured clinical interview for DSM-IV axis I disorders, the Yale Brown Obsessive-Compulsive Scale, the Beck Anxiety and Beck Depression Inventories, and the Brown Assessment of Beliefs Scale. To assess ToM skills, first- and second-order false-belief tests, a hinting test, a faux pas test, a reading the mind in the eyes test, and a double-bluff test were administered.
Patients with OCD had poorer ToM abilities than healthy controls. All ToM scores were significantly lower in the poor insight group than in the good insight group (p < .001). A significant negative correlation was found between the BABS-total scores and all the ToM test mean scores (p < .05).
The finding of significantly lower ToM skills in OCD with poor insight than in OCD with good insight may contribute to the idea of OCD with poor insight being a subtype with different clinical and neuropsychological characteristics.
已知自知力差的强迫症（OCD）患者比其他强迫症患者表现出更严重的神经心理学损害。关于强迫症与心理理论（ToM）的研究有限。
通过比较自知力好与自知力差的强迫症患者，调查强迫症患者的心理理论技能以及自知力与心理理论技能之间的关系。
80例强迫症患者和80名健康对照者完成了DSM-IV轴I障碍的结构化临床访谈、耶鲁布朗强迫症量表、贝克焦虑量表和贝克抑郁量表，以及信念评估量表。为评估心理理论技能，进行了一阶和二阶错误信念测试、暗示测试、失礼测试、眼神读心测试和双重虚张声势测试。
强迫症患者的心理理论能力比健康对照者差。自知力差组的所有心理理论得分均显著低于自知力好组（p <.001）。信念评估量表总分与所有心理理论测试平均得分之间存在显著负相关（p <.05）。
自知力差的强迫症患者的心理理论技能显著低于自知力好的强迫症患者，这一发现可能支持自知力差的强迫症是具有不同临床和神经心理学特征的亚型这一观点。
