Association between obsession, compulsion, depression and insight in obsessive-compulsive disorder: a meta-analysis.

BACKGROUND

Previous studies examining potential relationships of impaired insight with severity obsessive-compulsive (O-C) symptoms and depressive symptoms in patients diagnosed with obsessive-compulsive disorder (OCD) have produced mixed results. Here, we examined differences in these clinical characteristics and their changes after treatment in adult patients with OCD who have poor insight (OCD-PI) versus in those who have good insight (OCD-GI).

METHODS

Fifty-nine full-text articles were screened for eligibility with 20 studies ultimately being included in the present meta-analysis.

RESULTS

The OCD-PI and OCD-GI groups differed from each other with respect to O-C symptom ( < 0.001,  > 0.7) and depressive symptom ( < 0.001,  = 0.614) severity. Significant and moderate correlations were observed between insight and treatment outcomes (O-C symptoms,  = 0.33; depressive symptoms,  = 0.47). Exploratory meta-regression showed that methodological factors influenced the magnitudes of inter-group O-C symptom differences.

CONCLUSIONS

The current meta-analysis indicates that poorer insight is associated with more severe O-C and depression, and less improvement of symptoms in patients with OCD. Insight impairment may be a critical and core OCD-related deficit.