Metacognitions and automatic thoughts in obsessive compulsive disorder

Obsessive Compulsive Disorder (OCD) is a chronic, psychiatric disorder that causes loss of professional and social functions. Lee and Kwon analyzed obsessions in two separate groups as autogenous and reactive obsessions, based on their studies on cognitive theory. At this study, OCD patients with autogenous and reactive obsessions were compared with healthy control group in terms of differences in their metacognitions and automatic thoughts. Also anxiety and depression levels of the autogenous and reactive groups were analyzed in terms of their gender, educational level, place of living, family story and received treatments. Healthy voluntary people as healthy control group and the patients who applied Karadeniz Technical University (KTU) Medical Faculty psychiatry outpatient clinic and got Obsessive-Compulsive Disorder (OCD) diagnosis between the dates of December 2014 - January 2014 were accepted to this study as objects. Also, acceptance of participating to the study and having the eligibility criteria were the inclusion criteria to the study. The participants were kept informed about the study and their written consents were taken. The decision number 2014/6 of KTU Clinical Research Committee was taken as the ethical committee approval. Patients (autogenous group) who have primary obsessions defined as autogenous (patients those have aggressive, sexual and religious obsessions according to the Yale Brown Obsessive Compulsive Scale (Y-BOCS) symptom checklist) and patients (reactive group) who have obsessions defined as reactive (patients who have contamination, symmetry, somatic, doubt and etc. obsessions according to the Y-BOCS symptom checklist). All of the patients were evaluated by Sociodemographic Data Form, SCID-I, Y-BOCS (Yale-Brown Obsessive-Compulsive Scale), MCQ -30 (Metacognition Questionnaire), ATQ (Automathic Thoughts Questionnaire), BAI (Beck Anxiety Inventory), BDR (Beck Depression Questionnaire). Autogenous, reactive and healthy control groups were compared with each other by using their sociodemographic datas, Y-BOCS, MCQ-30, OTQ, BDQ, BAI points. No difference was found between groups with regard to age, martial status, educational status, income level and place of living. Male gender of the autogenous group was significantly higher than the reactive group. Aggressiveness as the most common obsession in the autogenous group and contamination as the most common obsession in the reactive group was determined. The most common compulsion in the reactive group was cleaning/washing compulsions, and mental compulsions were the most common one in the autogenous group. There was no significant difference between the received treatment of the autogenous and reactive groups. All the scale points of the OCD group were significantly higher than the healthy control group. However, "uncontrollability and danger" and "need to control thoughts" subscales were higher in the autogenous group than reactive group. As a result, there is a significant difference between autogenous and reactive groups in terms of metacognitions and automatic thoughts. Results of this study shows that suggested classification could be useful for determining the subtypes of OCD. Also this subtype classification of OCD seems important for understanding the evolution of OCD, defining its symptoms and giving the most appropriate treatment.