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Personality organization in obsessive compulsive disorder with and without insight

Year 2019, Volume: 44 Issue: 1, 18 - 26, 31.03.2019
https://doi.org/10.17826/cumj.447337

Abstract

Purpose: The aim of this study was to investigate personality organization level in patients with and without insight of Obsessive Compulsive Disorder (OCD).

Materials and Methods: We conducted a cross-sectional study in Erenkoy Psychiatry and Neurological Diseases Training and Research Hospital. The study's universe consisted of 100 patients who applied with OCD diagnosis to Anxiety Policlinic of our hospital. Sociodemographic data form and Yale Brown Obsessive-Compulsive scale (Y-BOCS) Personality Organization Diagnostic Form (PODF) was completed for each participant at the first interview. 

Results: The proportion of patients with poor insight group in our study was 23%. Significant differences were found between the Y-BOCS general severity scores of the groups.The patients in two groups achieved significantly different total scores in identity, scores in primitive and mature defense mechanisms and reality testing. There was significant difference between patients with good insight OCD and poor insight OCD in terms of general personality organization. The total score of PODF identity had a predictive effect on insight in the linear direction.

Conclusion: The present study indicated that patients with poor insight OCD had lower level of personality organization as compared to patients with good insight OCD. According to the scores obtained in the subscales of PODF, patients with poor insight OCD showed high diffusion identity as compared to patients with good insight OCD. Besides this, it was observed that the group with poor insight mostly used primitive defense mechanisms, their reality testing was relatively disturbed and they had low level of object relations. 


References

  • KAYNAKLAR
  • 1. Bulut S, Fistikci N, Topçuoglu V. Içgörüsü Az Olan Obsesif-Kompulsif Bozukluk/Obsessive-Compulsive Disorder with Poor Insight. Psikiyatr Guncel Yaklasimlar. Psikiyatride Guncel Yaklasimlar: Current Approaches in Psychiatry; 2014;6(2):126.
  • 2. Pitman RK. Pierre Janet on obsessive-compulsive disorder (1903): review and commentary. Arch Gen Psychiatry. American Medical Association; 1987;44(3):226–32.
  • 3. American Psychiatric Association. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-IV),. 4 th editi. Washington DC; 1994.
  • 4. Foa EB, Kozak MJ. DSM-IV field trial: Obsessive-compulsive disorder. Am J Psychiatry. American Psychiatric Association; 1995;152(1):90.
  • 5. Eisen JL, Rasmussen SA, Phillips KA, Price LH, Davidson J, Lydiard RB, et al. Insight and treatment outcome in obsessive-compulsive disorder. Compr Psychiatry. Elsevier; 2001;42(6):494–7.
  • 6. Marazziti D, Dell’Osso L, Di Nasso E, Pfanner C, Presta S, Mungai F, et al. Insight in obsessive-compulsive disorder: a study of an Italian sample. EurPsychiatry. 2002;17(0924–9338 LA–eng PT–Journal Article SB–IM):407–10.
  • 7. Türksoy N, Tükel R, Karaveli D. İçgörüsü tam ve içgörüsü az olan obsesif kompulsif bozukluk hastalarının klinik özellikleri açısından karşılaştırılması. Turk Psikiyatr Derg. 1997;8:1–7.
  • 8. Kishore VR, Samar R, Reddy YCJ, Chandrasekhar CR, Thennarasu K. Clinical characteristics and treatment response in poor and good insight obsessive–compulsive disorder. Eur Psychiatry. Elsevier; 2004;19(4):202–8.
  • 9. Alonso P, Menchón JM, Segalàs C, Jaurrieta N, Jiménez-Murcia S, Cardoner N, et al. Clinical implications of insight assessment in obsessive-compulsive disorder. Compr Psychiatry. 2008;49(3):305–12.
  • 10. Matsunaga H, Kiriike N, Miyata A, Iwasaki Y, Matsui T, Nagata T, et al. Personality disorders in patients with obsessive-compulsive disorder in Japan. Acta Psychiatr Scand. 1998;98(2):128–34.
  • 11. Jakubovski E, Pittenger C, Torres AR, Fontenelle LF, do Rosario MC, Ferrão YA, et al. Dimensional correlates of poor insight in obsessive–compulsive disorder. Prog Neuro-Psychopharmacology Biol Psychiatry. Elsevier; 2011;35(7):1677–81.
  • 12. Bellino S, Patria L, Ziero S, Bogetto F. Clinical picture of obsessive-compulsive disorder with poor insight: a regression model. Psychiatry Res. Elsevier; 2005;136(2–3):223–31.
  • 13. Poyurovsky M, Fuchs C, Faragian S, Kriss V, Weisman G, Pashinian A, et al. Preferential Aggregation of Obsessive—Compulsive Spectrum Disorders in Schizophrenia Patients with Obsessive—Compulsive Disorder. Can J Psychiatry. SAGE Publications Sage CA: Los Angeles, CA; 2006;51(12):746–54.
  • 14. Catapano F, Perris F, Fabrazzo M, Cioffi V, Giacco D, De Santis V, et al. Obsessive–compulsive disorder with poor insight: a three-year prospective study. Prog Neuro-Psychopharmacology Biol Psychiatry. Elsevier; 2010;34(2):323–30.
  • 15. Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, et al. Yale-brown obsessive compulsive scale (Y-BOCS). Arch gen psychiatry. Springer; 1989;46:1006–11.
  • 16. Kaan KO, Murat ÜA, Mehmet U. Yale-Brown Obsesyon-Kompülsiyon Derecelendirme Ölçeğinin Geçerlik ve Güvenilirlik Çalışması. In: 29 Ulusal Psikiyatri Kongresi Program ve Bildiri Özetleri Kitabı. Bursa; 1993. p. 86.
  • 17. Diguer L, Lefebvre R, Drapeau M, Luborsky L, Rousseau J-P, Hébert É, et al. The core conflictual relationship theme of psychotic, borderline, and neurotic personality organizations. Psychother Res. Taylor & Francis; 2001;11(2):169–86.
  • 18. Gamache D, Laverdiere O, Diguer L, Hebert E, Larochell S, Descoteaux J. The Personality Organization Diagnostic Form-II. Interrater reliability and internal validity study. Rome, Italy; 2004.
  • 19. Hébert É, Diguer L, Descôteaux J, Daoust J-P, Rousseau J-P, Normandin L, et al. The Personality Organization Diagnostic Form (PODF): A preliminary report on its validity and interrater reliability. Psychother Res. Taylor & Francis; 2003;13(2):243–54. 20. Hébert É, Diguer L. Construct validity and interrater reliability of the Personality Organization Diagnostic Form (PODF). In: In annual meeting of the Society for Psychotherapy Research. 1999.
  • 21. Diguer L, Hébert É, Gamache D, Laverdière O, Daoust JP, Pelletier S. Personality Organization Diagnostic Form, II: Manual for Scoring (unpublished manuscript). Québec Univ Laval. 2006;
  • 22. Yılmaz Y, Sayğılı İ, Bilge D, Çınar S, Bodur NE, Bayrak A, et al. Erenköy kişilik örgütlenmesi tanı formu faktör yapısı güvenirliği ve geçerliği. In: 48 Ulusal psikiyatri kongresi, sözel bildiri. 2012.
  • 23. Cherian A V., Narayanaswamy JC, Srinivasaraju R, Viswanath B, Math SB, Kandavel T, et al. Does insight have specific correlation with symptom dimensions in OCD? J Affect Disord [Internet]. Elsevier B.V.; 2012;138(3):352–9. Available from: http://dx.doi.org/10.1016/j.jad.2012.01.017
  • 24. Kernberg O. Severe Personality Disorders (Psychotherapeutic Strategies. New Haven (Yale University Press) 1984. 1984;
  • 25. Pila A, Anna S. The sense of identity and symptoms of personality disorders – The results of a non-clinical population study. 2015;49(3):599–613.
  • 26. Diguer L, Gamache D, Laverdière O. Development and initial validity of the Object Relations Rating Scale. Psychother Res. 2012;22(4):402–16.
  • 27. Kernberg OF. Borderline Conditions and Pathological Narcissism. New York: Jason Aronson; 1975.
  • 28. Kernberg OF. Object Relations Theory and Clinical Psychoanalysis. New Jersey: Jason Aronson; 1976.
  • 29. Dereboy İF, Dereboy Ç, Sevİnçok L. Gençlerde Kimlik Gelişimi Sürecini Değerlendirmekte Kullanılan iki Ölçeğin Psikometrik Özellikleri : Karşılaştırmalı Bir Çalışma *. 1999;10(2):92–101.
  • 30. Blatt SJ. Representational structures in psychopathology. University of Rochester Press; 1995;
  • 31. Kernberg OF. A psychoanalytic theory of personality disorders. In: Lenzenweger MF, Clarkin JF, editors. Major theories of personality disorders. Newyork: The Guilford Press; 1996. p. 106–40.
  • 32. Fricke S, Moritz S, Andresen B, Hand I, Jacobsen D, Kloss M, et al. Einfluss von Persönlichkeitsstörungen auf den Erfolg einer multimodalen Verhaltenstherapie bei Zwangserkrankungen–Teil II: Ergebnisse einer empirischen Studie. Verhaltenstherapie. Karger Publishers; 2003;13(3):172–82.
  • 33. Shimshoni Y, Reuven O, Dar R, Hermesh H. Insight in obsessive-compulsive disorder: a comparative study of insight measures in an Israeli clinical sample. J Behav Ther Exp Psychiatry. Elsevier; 2011;42(3):389–96.

İçgörüsü olan ve olmayan obsesif kompulsif bozukluk hastalarında kişilik örgütlenmesi

Year 2019, Volume: 44 Issue: 1, 18 - 26, 31.03.2019
https://doi.org/10.17826/cumj.447337

Abstract

Amaç: Bu çalışmada içgörüsü olan ve olmayan Obsesif Kompulsif Bozukluk (OKB) hastalarında, kişilik örgütlenme düzeyini araştırmayı amaçlanmıştır.

Gereç ve Yöntem: Kesitsel tipte gerçekleştirilen çalışmamız Erenköy Ruh ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesinde gerçekleştirildi. Çalışmanın evrenini hastanemiz Anksiyete Polikliniğine başvuran ve yatan hasta servislerine OKB tanısı ile izlemi yapılan 100 OKB hastası oluşturdu. Tüm katılımcılara Sosyodemografik veri formu, Yale Brown Obsesif Kompulsif Bozukluk Ölçeği (Y-BOCS) ve Kişilik Örgütlenmesi Tanı Formu (KÖTF) uygulandı.

Bulgular: Çalışmamızda içgörüsü olmayan hasta grubu evrenin %23’ünü oluşturdu. Grupların Y-BOCS genel şiddet ortalamaları arasında anlamlı farklılık saptandı. KÖTF’ün alt-boyutlarından kimlik toplam, ilkel ve olgun savunma düzenekleri toplam ve gerçeği değerlendirme toplam puanları anlamlı farklılık gösterdi. KÖTF’e göre hastaların genel kişilik örgütlenmeleri gruplara göre anlamlı farklılık gösterdi. KÖTF’nin kimlik toplam puanın doğrusal yönde, içgörü üzerinde yordayıcı bir etkiye sahip olduğu belirlenmiştir.

Sonuç: Bu çalışmada içgörüsü olmayan OKB hastalarının, içgörüsü olan OKB hastalarına oranla daha düşük düzey kişilik örgütlenmesine sahip oldukları gösterildi. Kişilik örgütlenmesinin alt-boyutlarına bakıldığında içgörüsü olmayan OKB hastalarında kimliğin daha dağınık, kullandıkları savunma düzeneklerinin ağırlıklı olarak ilkel savunmalar olduğu, gerçeği değerlendirmelerinin görece daha bozuk olduğu ve daha düşük düzey nesne ilişkilerine sahip oldukları gösterildi.


References

  • KAYNAKLAR
  • 1. Bulut S, Fistikci N, Topçuoglu V. Içgörüsü Az Olan Obsesif-Kompulsif Bozukluk/Obsessive-Compulsive Disorder with Poor Insight. Psikiyatr Guncel Yaklasimlar. Psikiyatride Guncel Yaklasimlar: Current Approaches in Psychiatry; 2014;6(2):126.
  • 2. Pitman RK. Pierre Janet on obsessive-compulsive disorder (1903): review and commentary. Arch Gen Psychiatry. American Medical Association; 1987;44(3):226–32.
  • 3. American Psychiatric Association. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-IV),. 4 th editi. Washington DC; 1994.
  • 4. Foa EB, Kozak MJ. DSM-IV field trial: Obsessive-compulsive disorder. Am J Psychiatry. American Psychiatric Association; 1995;152(1):90.
  • 5. Eisen JL, Rasmussen SA, Phillips KA, Price LH, Davidson J, Lydiard RB, et al. Insight and treatment outcome in obsessive-compulsive disorder. Compr Psychiatry. Elsevier; 2001;42(6):494–7.
  • 6. Marazziti D, Dell’Osso L, Di Nasso E, Pfanner C, Presta S, Mungai F, et al. Insight in obsessive-compulsive disorder: a study of an Italian sample. EurPsychiatry. 2002;17(0924–9338 LA–eng PT–Journal Article SB–IM):407–10.
  • 7. Türksoy N, Tükel R, Karaveli D. İçgörüsü tam ve içgörüsü az olan obsesif kompulsif bozukluk hastalarının klinik özellikleri açısından karşılaştırılması. Turk Psikiyatr Derg. 1997;8:1–7.
  • 8. Kishore VR, Samar R, Reddy YCJ, Chandrasekhar CR, Thennarasu K. Clinical characteristics and treatment response in poor and good insight obsessive–compulsive disorder. Eur Psychiatry. Elsevier; 2004;19(4):202–8.
  • 9. Alonso P, Menchón JM, Segalàs C, Jaurrieta N, Jiménez-Murcia S, Cardoner N, et al. Clinical implications of insight assessment in obsessive-compulsive disorder. Compr Psychiatry. 2008;49(3):305–12.
  • 10. Matsunaga H, Kiriike N, Miyata A, Iwasaki Y, Matsui T, Nagata T, et al. Personality disorders in patients with obsessive-compulsive disorder in Japan. Acta Psychiatr Scand. 1998;98(2):128–34.
  • 11. Jakubovski E, Pittenger C, Torres AR, Fontenelle LF, do Rosario MC, Ferrão YA, et al. Dimensional correlates of poor insight in obsessive–compulsive disorder. Prog Neuro-Psychopharmacology Biol Psychiatry. Elsevier; 2011;35(7):1677–81.
  • 12. Bellino S, Patria L, Ziero S, Bogetto F. Clinical picture of obsessive-compulsive disorder with poor insight: a regression model. Psychiatry Res. Elsevier; 2005;136(2–3):223–31.
  • 13. Poyurovsky M, Fuchs C, Faragian S, Kriss V, Weisman G, Pashinian A, et al. Preferential Aggregation of Obsessive—Compulsive Spectrum Disorders in Schizophrenia Patients with Obsessive—Compulsive Disorder. Can J Psychiatry. SAGE Publications Sage CA: Los Angeles, CA; 2006;51(12):746–54.
  • 14. Catapano F, Perris F, Fabrazzo M, Cioffi V, Giacco D, De Santis V, et al. Obsessive–compulsive disorder with poor insight: a three-year prospective study. Prog Neuro-Psychopharmacology Biol Psychiatry. Elsevier; 2010;34(2):323–30.
  • 15. Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, et al. Yale-brown obsessive compulsive scale (Y-BOCS). Arch gen psychiatry. Springer; 1989;46:1006–11.
  • 16. Kaan KO, Murat ÜA, Mehmet U. Yale-Brown Obsesyon-Kompülsiyon Derecelendirme Ölçeğinin Geçerlik ve Güvenilirlik Çalışması. In: 29 Ulusal Psikiyatri Kongresi Program ve Bildiri Özetleri Kitabı. Bursa; 1993. p. 86.
  • 17. Diguer L, Lefebvre R, Drapeau M, Luborsky L, Rousseau J-P, Hébert É, et al. The core conflictual relationship theme of psychotic, borderline, and neurotic personality organizations. Psychother Res. Taylor & Francis; 2001;11(2):169–86.
  • 18. Gamache D, Laverdiere O, Diguer L, Hebert E, Larochell S, Descoteaux J. The Personality Organization Diagnostic Form-II. Interrater reliability and internal validity study. Rome, Italy; 2004.
  • 19. Hébert É, Diguer L, Descôteaux J, Daoust J-P, Rousseau J-P, Normandin L, et al. The Personality Organization Diagnostic Form (PODF): A preliminary report on its validity and interrater reliability. Psychother Res. Taylor & Francis; 2003;13(2):243–54. 20. Hébert É, Diguer L. Construct validity and interrater reliability of the Personality Organization Diagnostic Form (PODF). In: In annual meeting of the Society for Psychotherapy Research. 1999.
  • 21. Diguer L, Hébert É, Gamache D, Laverdière O, Daoust JP, Pelletier S. Personality Organization Diagnostic Form, II: Manual for Scoring (unpublished manuscript). Québec Univ Laval. 2006;
  • 22. Yılmaz Y, Sayğılı İ, Bilge D, Çınar S, Bodur NE, Bayrak A, et al. Erenköy kişilik örgütlenmesi tanı formu faktör yapısı güvenirliği ve geçerliği. In: 48 Ulusal psikiyatri kongresi, sözel bildiri. 2012.
  • 23. Cherian A V., Narayanaswamy JC, Srinivasaraju R, Viswanath B, Math SB, Kandavel T, et al. Does insight have specific correlation with symptom dimensions in OCD? J Affect Disord [Internet]. Elsevier B.V.; 2012;138(3):352–9. Available from: http://dx.doi.org/10.1016/j.jad.2012.01.017
  • 24. Kernberg O. Severe Personality Disorders (Psychotherapeutic Strategies. New Haven (Yale University Press) 1984. 1984;
  • 25. Pila A, Anna S. The sense of identity and symptoms of personality disorders – The results of a non-clinical population study. 2015;49(3):599–613.
  • 26. Diguer L, Gamache D, Laverdière O. Development and initial validity of the Object Relations Rating Scale. Psychother Res. 2012;22(4):402–16.
  • 27. Kernberg OF. Borderline Conditions and Pathological Narcissism. New York: Jason Aronson; 1975.
  • 28. Kernberg OF. Object Relations Theory and Clinical Psychoanalysis. New Jersey: Jason Aronson; 1976.
  • 29. Dereboy İF, Dereboy Ç, Sevİnçok L. Gençlerde Kimlik Gelişimi Sürecini Değerlendirmekte Kullanılan iki Ölçeğin Psikometrik Özellikleri : Karşılaştırmalı Bir Çalışma *. 1999;10(2):92–101.
  • 30. Blatt SJ. Representational structures in psychopathology. University of Rochester Press; 1995;
  • 31. Kernberg OF. A psychoanalytic theory of personality disorders. In: Lenzenweger MF, Clarkin JF, editors. Major theories of personality disorders. Newyork: The Guilford Press; 1996. p. 106–40.
  • 32. Fricke S, Moritz S, Andresen B, Hand I, Jacobsen D, Kloss M, et al. Einfluss von Persönlichkeitsstörungen auf den Erfolg einer multimodalen Verhaltenstherapie bei Zwangserkrankungen–Teil II: Ergebnisse einer empirischen Studie. Verhaltenstherapie. Karger Publishers; 2003;13(3):172–82.
  • 33. Shimshoni Y, Reuven O, Dar R, Hermesh H. Insight in obsessive-compulsive disorder: a comparative study of insight measures in an Israeli clinical sample. J Behav Ther Exp Psychiatry. Elsevier; 2011;42(3):389–96.
There are 33 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research
Authors

Fikret Ferzan Gıynaş 0000-0001-8280-2979

Özlem Kazan Kızılkurt 0000-0001-7121-9139

Medine Yazıcı Güleç 0000-0002-7279-0916

Hüseyin Güleç 0000-0002-9227-9373

Publication Date March 31, 2019
Acceptance Date July 31, 2018
Published in Issue Year 2019 Volume: 44 Issue: 1

Cite

MLA Gıynaş, Fikret Ferzan et al. “İçgörüsü Olan Ve Olmayan Obsesif Kompulsif Bozukluk hastalarında kişilik örgütlenmesi”. Cukurova Medical Journal, vol. 44, no. 1, 2019, pp. 18-26, doi:10.17826/cumj.447337.