Skip to main content
    • Aa
    • Aa

Obsessive-compulsive beliefs and treatment outcome

  • P. T. Lelliott (a1), H. F. Noshirvani (a1), M. Başoǧlu (a1), I. M. Marks (a1) and W. O. Monteiro (a1)...

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.

Corresponding author
1Address for correspondence: Professor Isaac Marks, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF.
Hide All
Basoǧlu M., Lax T., Kasvikis Y. & Marks I. M. (1988). Predictors of outcome in obsessive-compulsive disorder. Submitted for publication.
Beck A. T., Rial W. Y. & Rickels K. (1974). Short form of depression inventory: cross validation. Psychological Reports 34, 11841186.
Foa E. B. (1979). Failure in treating obsessive-compulsives. Behaviour Research and Therapy 17, 169176.
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.
Hamilton M. (1969). Standardized assessment and recording of depressive symptoms. Psychiatrica Neurological Neurochirurgia 72, 201205.
Insel T. R. & Akiskal H. S. (1986). Obsessive-compulsive disorder with psychotic features: a phenomenologic analysis. American Journal of Psychiatry 143, 15271533.
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, 530532.
Lelliott P. T. & Marks I. M. (1987). Management of obsessive compulsive rituals associated with delusions, hallucinations and depression: a case report. Behavioural Psychotherapy 15, 7787.
Lewis A. (1936). Problems of obsessional illness. Proceedings of The Royal Society of Medicine 29, 1324.
Lewis A. (1960). Obsessional illness. In Inquiries in Psychiatry, Routledge & Kegan Paul: London.
Marks I. M. (1987). Fears, Phobias and Rituals. Oxford University Press: New York.
Marks I. M. & Mishan J. (1988). Behavioural treatment for dysmorphophobia. British Journal of Psychiatry. (In the press.)
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, 125.
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.)
Salkovskis P. M. & Warwick H. M. C. (1985). Cognitive therapy of obsessive-compulsive disorder: treating treatment failures. Behavioural Psychotherapy 13, 243255.
Stern R. S. & Cobb J. P. (1978). Phenomenology of obsessive compulsive neurosis. British Journal of Psychiatry 132, 233239.
Walker V. J. (1973). Explanation in obsessional neurosis. British Journal of Psychiatry 123, 675680.
Walker V. J. & Beech H. R. (1969). Mood state and ritualistic behaviour of obsessional patients. British Journal of Psychiatry 115, 12611268.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 8 *
Loading metrics...

Abstract views

Total abstract views: 154 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 19th October 2017. This data will be updated every 24 hours.