Wolf Nadja, du Mortier Johanna A M, van Oppen Patricia, Hoogendoorn Adriaan W, van Balkom Anton J L M, Visser Henny A D
Mental Health Care Institute Geestelijke gezondheidszorg (GGZ) Centraal, Amersfoort, Netherlands.
Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, Netherlands.
Front Psychiatry. 2023 Oct 13;14:1231293. doi: 10.3389/fpsyt.2023.1231293. eCollection 2023.
Patients with obsessive-compulsive disorder (OCD) and poor insight show higher symptom severity, lower quality of life (QoL), and a reduced treatment response compared to patients with good insight. Little is known about changes in insight. This study explored the course of insight and its association with OCD severity and QoL among 253 patients with OCD participating in the prospective naturalistic Netherlands Obsessive Compulsive Disorder Association (NOCDA) Study.
In 70% of the participants with available insight data, the level of insight changed during the four-year course. Insight was most variable in participants with poor insight. Improvement of insight scores was statistically significantly associated with improvement of Y-BOCS scores ( = 0.19), but not with changes in QoL scores. Change in insight in the first 2 years was not statistically significantly predictive of OCD severity or QoL at four-year follow-up.
These findings suggest that patients' levels of insight may change during the natural four-year course of OCD and that improvement in the level of insight have a positive association with improvement in OCD severity.
与自知力良好的强迫症（OCD）患者相比，自知力差的OCD患者症状更严重，生活质量（QoL）更低，治疗反应也更差。关于自知力的变化知之甚少。本研究在参与前瞻性自然主义荷兰强迫症协会（NOCDA）研究的253例OCD患者中，探讨了自知力的变化过程及其与OCD严重程度和QoL的关系。
在有自知力可用数据的参与者中，70%的人在四年的病程中自知力水平发生了变化。自知力最差的参与者自知力变化最大。自知力得分的改善与Y-BOCS得分的改善在统计学上显著相关（=0.19），但与QoL得分的变化无关。前两年自知力的变化在四年随访时对OCD严重程度或QoL没有统计学上的显著预测作用。
这些发现表明，在OCD自然病程的四年中，患者的自知力水平可能会发生变化，自知力水平的改善与OCD严重程度的改善呈正相关。
