Schizotypy and formal thought disorder in patients with obsessive compulsive disorder

Objective: Although insight and resistance to obsessions in OCD have been shown to be linked to OCD subtypes and to schizotypy, relationship of these variables to thought disorder has not been examined.. The aim of this study is to investigate the effect of schizotypy and thought disorders on insight and resistance in obsessive-compulsive disorder. Method: 76 participants diagnosed with DSM-5 OCD, who were admitted to the Psychiatry Clinic of Hacettepe University Hospital, and who did not have any psychiatric, neurologic or physical illness that might interfere with the evaluation and interviews, were invited to participate in the study. The participants were first given a structured interview (Structured Clinical Interview for DSM-5 Disorders-Clinician Version-SCID-5/CV), followed by the following semi-structured interviews: the Yale Brown Obsessive Compulsive Scale (Y-BOCS), Schizotypal Personality Schedule (SSP), and Thought and Language Disorder Scale (TALD). Good insight vs. poor insight and high resistance vs. low resistance groups were compared in terms of demographic variables, OCD subtype, schizotypy and thought disorder. Independent predictors of insight and resistance were also examined. Results: Univariate analyses showed a correlation between insight and Y-BOCS total score, the positive dimension of SSP, subjective and negative formal thought disorders (TALD). In regression analysis, it was found that TALD positive score was a negative predictor and YBOCS total score was a positive predictor of insight. In the analysis of resistance to obsessions, it was found that insight and YBOCS total score were positive predictors. Conclusion: In this cross-sectional study, it was found that the strongest determinant of both insight and resistance to symptoms was the severity of the illness. These findings were consistent with previous studies except that TALD positive score was a negative predictor of insight, which may be due to the unsuitability of our assessment tool for measuring thought disorder in OCD.