The relationship between theory of mind and insight in obsessive-compulsive disorder

• Published in: Nordic journal of psychiatry Vol. 72; no. 4; pp. 273 - 280
• Main Authors: Tulacı, Rıza Gökçer, Cankurtaran, Eylem Şahin, Özdel, Kadir, Öztürk, Nefise, Kuru, Erkan, Özdemir, İlker
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 19-05-2018
• Subjects: insight; Obsessive-compulsive disorder; theory of mind; theory of mind; insight; Obsessive-compulsive disorder
• ISSN: 0803-9488; 1502-4725
• DOI: 10.1080/08039488.2018.1436724

Background: It is known that obsessive-compulsive disorder (OCD) patients with poor insight display more severe neuropsychological impairments than other patients with OCD. There are limited studies of OCD and theory of mind (ToM).
Aim: To investigate ToM skills in patients with OCD and the relationship between insight and ToM skills by comparing OCD patients with good and poor insight.
Methods: Eighty patients with OCD and 80 healthy controls completed the structured clinical interview for DSM-IV axis I disorders, the Yale Brown Obsessive-Compulsive Scale, the Beck Anxiety and Beck Depression Inventories, and the Brown Assessment of Beliefs Scale. To assess ToM skills, first- and second-order false-belief tests, a hinting test, a faux pas test, a reading the mind in the eyes test, and a double-bluff test were administered.
Results: Patients with OCD had poorer ToM abilities than healthy controls. All ToM scores were significantly lower in the poor insight group than in the good insight group (p < .001). A significant negative correlation was found between the BABS-total scores and all the ToM test mean scores (p < .05).
Conclusions: The finding of significantly lower ToM skills in OCD with poor insight than in OCD with good insight may contribute to the idea of OCD with poor insight being a subtype with different clinical and neuropsychological characteristics.