Symptom Insight in Pediatric Obsessive-Compulsive Disorder: Outcomes of an International Aggregated Cross-Sectional Sample

Abstract

Insight in obsessive-compulsive disorder (OCD) refers to patients’ recognition that their obsessions and compulsions are symptoms rather than necessary or natural thoughts and behaviors. 1 It has been estimated that 20% to 45% of youth with OCD exhibit poor or absent insight. 2-4 Identified correlates of poor insight include younger age, 2,3,5,6 increased OCD severity, 2,4,7 impairment, 4,7,8 and family accommodation 2,4 ; lower intellectual and adaptive functioning 3 ; and greater depressive symptoms. 2,3 Poorer insight has also been associated with reduced response across treatment groups (ie, selective serotonin reuptake inhibitor [SSRI], cognitive behavioral therapy [CBT], combined SSRI plus CBT, or pill placebo). 9