The relationship of autogenous obsessions in obsessive-compulsive disorder with psychosis-like experiences, impulsivity, defense mechanisms and psychological resilience

Objective: When autogenic and reactive obsessions, which are a classification belonging to cognitive theory, are compared, it is seen that they show different characteristics in many aspects. Studies in this field have mostly been limited to neurobiological fields. This study aims to determine the qualitative differences between psychosis-like experiences, impulsivity, defense mechanisms, and psychological resilience in order to evaluate the relationship between the presence of autogenic obsession and ego strength and ego functional level, which are psychodynamic concepts. Method: 96 OCD patients who were diagnosed with OCD through a follow-up SCID-5 interview at the Celal Bayar University Hafsa Sultan Hospital Psychiatry Outpatient Clinic, who agreed to participate in our study, whose consent forms were obtained, and who met the inclusion criteria were taken as a sample. Each patient participating in the study was administered the Yale-Brown Obsession Compulsion Scale (YBOCS)-Symptom Checklist, Community Assessment of Psychic Experiences (CAPE) scale, Barratt Impulsivity Scale short form (BIS), Resilience Scale for Adults (RSS), Defense Styles Test (DST-40), Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HADS) respectively. Chi-square test, Shapiro-Wilk test, Student t test or Mann Whitney U test were used in statistical analysis. In terms of statistical significance, significance was accepted as p<0.05 at 95% confidence interval. Binary logistic regression was applied by establishing models with variables that were found to be significant in further analysis. Results: When the data related to the disease were evaluated; It was found that the number of hospitalizations, participation in regular check-ups, and previous psychotropic drug use were higher and the age at first diagnosis was earlier in the group with autogenic obsession. Perceptual abnormalities, bizarre experiences, delusional thoughts, immature defenses, motor impulsivity, attentional impulsivity, failure to plan, and total impulsivity scores were significantly higher in the group with autogenic obsession than in the pure reactive group. In the pure reactive group, the levels of social competence, family coherence, personal structure, future perception, and self-perception, which are factors of psychological resilience, were significantly higher than in the group with autogenic obsession. Conclusion: It was concluded that earlier age of first diagnosis, more perceptual abnormalities and bizarre experiences, increased obsessive severity and motor impulsivity, and weakness in the structural style area within the concept of resilience are associated with the presence of autogenic obsession. However, due to limitations, it is thought that more comprehensive and prospective studies are needed. Keywords: Obsessive compulsive disorder, autogenous obsession, ego functions, psychosis-like experiences, impulsivity, defense mechanisms, resilience