Hostname: page-component-76fb5796d-25wd4 Total loading time: 0 Render date: 2024-04-26T20:56:49.479Z Has data issue: false hasContentIssue false
  • English
  • Français

Obsessive-compulsive beliefs and treatment outcome

Published online by Cambridge University Press:  09 July 2009

P. T. Lelliott ,
H. F. Noshirvani ,
M. Başoǧlu ,
I. M. Marks  and
W. O. Monteiro
P. T. Lelliott
Affiliation:
Department of Experimental Psychopathology, Institute of Psychiatry, London
H. F. Noshirvani
Affiliation:
Department of Experimental Psychopathology, Institute of Psychiatry, London
M. Başoǧlu
Affiliation:
Department of Experimental Psychopathology, Institute of Psychiatry, London
I. M. Marks*
Affiliation:
Department of Experimental Psychopathology, Institute of Psychiatry, London
W. O. Monteiro
Affiliation:
Department of Experimental Psychopathology, Institute of Psychiatry, London
*
1Address for correspondence: Professor Isaac Marks, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF.
Get access Rights & Permissions [Opens in a new window]

Synopsis

Of 49 compulsive ritualizers one-third perceived their obsessive thoughts as rational and felt that their rituals warded off some unwanted or feared event (the content of their obsessions). The more bizarre the obsessive belief the more strongly it was defended and 12% of cases made no attempt to resist the urge to ritualize. Neither fixity of belief nor resistance to compulsive urges were related to duration of illness. Patients with bizarre and fixed obsessive beliefs responded as well to treatment (all but three received exposure), as did patients whose obsessions were less bizarre and recognized as senseless. There was no difference in outcome between patients who initially found it hard to control their obsessions or never resisted the urge to ritualize and those who initially could control obsessions or resist rituals. One year after starting treatment, patients whose obsessions and compulsions had improved with treatment recognized their irrationality more readily and controlled their compulsive urges more easily. Beliefs appeared to normalize as a function of habituation.

Type
Research Article
Information
Psychological Medicine , Volume 18 , Issue 3 , August 1988 , pp. 697 - 702
Copyright
Copyright © Cambridge University Press 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Basoǧlu, M., Lax, T., Kasvikis, Y. & Marks, I. M. (1988). Predictors of outcome in obsessive-compulsive disorder. Submitted for publication.Google Scholar
Beck, A. T., Rial, W. Y. & Rickels, K. (1974). Short form of depression inventory: cross validation. Psychological Reports 34, 1184–1186.CrossRefGoogle ScholarPubMed
Foa, E. B. (1979). Failure in treating obsessive-compulsives. Behaviour Research and Therapy 17, 169–176.CrossRefGoogle ScholarPubMed
Freedman, A. M., Kaplan, H. I. & Sadock, B. J. (1972). Obsessive compulsive neurosis. In Modern Synopsis of Comprehensive Textbook of Psychiatry, Williams and Wilkins: Baltimore.Google Scholar
Hamilton, M. (1969). Standardized assessment and recording of depressive symptoms. Psychiatrica Neurological Neurochirurgia 72, 201–205.Google ScholarPubMed
Insel, T. R. & Akiskal, H. S. (1986). Obsessive-compulsive disorder with psychotic features: a phenomenologic analysis. American Journal of Psychiatry 143, 1527–1533.Google ScholarPubMed
Jenike, M. A., Baer, L., Minichiello, W. E., Schwartz, C. E. & Carey, R. J. (1986). Concomitant obsessive-compulsive disorder and schizotypal personality disorder. American Journal of Psychiatry 143, 530–532.Google ScholarPubMed
Lelliott, P. T. & Marks, I. M. (1987). Management of obsessive compulsive rituals associated with delusions, hallucinations and depression: a case report. Behavioural Psychotherapy 15, 77–87.CrossRefGoogle Scholar
Lewis, A. (1936). Problems of obsessional illness. Proceedings of The Royal Society of Medicine 29, 13–24.Google ScholarPubMed
Lewis, A. (1960). Obsessional illness. In Inquiries in Psychiatry, Routledge & Kegan Paul: London.Google Scholar
Marks, I. M. (1987). Fears, Phobias and Rituals. Oxford University Press: New York.Google Scholar
Marks, I. M. & Mishan, J. (1988). Behavioural treatment for dysmorphophobia. British Journal of Psychiatry. (In the press.)Google Scholar
Marks, I. M., Stern, R. S., Mawson, D., Cobb, J. & McDonald, R. (1980). Clomipramine and exposure for obsessive compulsive rituals. I. British Journal of Psychiatry 136, 1–25.CrossRefGoogle Scholar
Marks, I. M., Lelliott, P., Basoǧlu, M., Noshirvani, H., Monteiro, W. O., Cohen, S. D. & Kasvikis, Y. (1988). Clomipramine, self-exposure and therapist-aided exposure in obsessive-compulsive ritualisers. British Journal of Psychiatry. (In the press.)CrossRefGoogle Scholar
Salkovskis, P. M. & Warwick, H. M. C. (1985). Cognitive therapy of obsessive-compulsive disorder: treating treatment failures. Behavioural Psychotherapy 13, 243–255.CrossRefGoogle Scholar
Stern, R. S. & Cobb, J. P. (1978). Phenomenology of obsessive compulsive neurosis. British Journal of Psychiatry 132, 233–239.CrossRefGoogle Scholar
Walker, V. J. (1973). Explanation in obsessional neurosis. British Journal of Psychiatry 123, 675–680.CrossRefGoogle ScholarPubMed
Walker, V. J. & Beech, H. R. (1969). Mood state and ritualistic behaviour of obsessional patients. British Journal of Psychiatry 115, 1261–1268.CrossRefGoogle Scholar