Skip to main content
×
×
Home

Obsessive-compulsive disorder and delusions revisited

  • Anne-Marie O'Dwyer (a1) and Isaac Marks (a1)
Abstract
Background

The concept of fixed, unshakeable (delusional) beliefs within the context of obsessive–compulsive disorder (OCD) is one that has received varying amounts of attention in the literature, and has not yet received universal acknowledgement. There are good grounds for including these cases within the diagnostic concepts of OCD, with significant implications for clinical management.

Aims

To present cases with unusual OCD, in order to re-evaluate the issue of delusions and OCD.

Method

The cases of five subjects with delusions in the course of obsessive–compulsive disorder are presented to illustrate ‘delusional’ OCD. The management and outcome of these cases are discussed.

Results

Fixity and bizarreness of beliefs in OCD occur on a continuum from ‘none’ to ‘delusional intensity’ and may fluctuate within subjects.

Conclusions

The idea that these cases may represent a form of OCD has implications for management, as, if this is correct, they should be able to respond to appropriate behavioural and/or pharmacological strategies used in OCD.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Obsessive-compulsive disorder and delusions revisited
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Obsessive-compulsive disorder and delusions revisited
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Obsessive-compulsive disorder and delusions revisited
      Available formats
      ×
Copyright
Corresponding author
Professor I. M. Marks, Maudsley Hospital, De Crespigny Park, Denmark Hill, London SE5 8AZ
Footnotes
Hide All

Declaration of interest

None.

Footnotes
References
Hide All
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.
Bruch, H. (1962) Perceptual and conceptual disturbance in anorexia nervosa. Psychosomatic Medicine, 24, 187194.
Eisen, J. & Rasmussen, S. A. (1993) Obsessive compulsive disorder with psychotic features. Journal of Clinical Psychiatry, 54, 373379.
Fear, C. & Healy, D. (1995) Obsessive compulsive disorders and delusional disorders: notes on their history, nosology and interface. Journal of Serotonin Research, 1 (suppl. 1), 113.
Foa, E. B. (1979) Failures in treating obsessive–compulsive disorder. Behaviour Research and Therapy, 17, 169176.
Insel, T. R. & Akiskal, H. S. (1986) Obsessive–compulsive disorder with psychotic features: A phenomenologic analysis. American Journal of Psychiatry, 143, 15271533.
Lelliott, P. & Marks, I. (1987) Management of obsessive–compulsive rituals associated with delusions, hallucinations and depression: A case report. Behavioural Psychotherapy, 15, 7787.
Lelliott, P., Noshirvani, H. F., Basoglu, M., et al (1988) Obsessive–compulsive beliefs and treatment outcome. Psychological Medicine, 18, 697702.
Lewis, A. (1935) Problems of obsessional illness. Proceedings of the Royal Society of Medicine, 29, 325336.
Maj, M. (1998) Critique of the DSM–IV operational diagnostic criteria for schizophrenia. British Journal of Psychiatry, 172, 458460.
McKenna, P. J. (1984) Disorders with overvalued ideas. British Journal of Psychiatry, 145, 579585.
Phillips, K. A., Kim, J. M. & Hudson, J. I. (1995) Body image disturbance in body dysmorphic disorder and eating disorders – obsessions or delusions? Psychiatric Clinics of North America, 18, 317334.
Rosen, I. (1957) The clinical significance of obsessions in schizophrenia. Journal of Mental Science, 103, 773785.
Solyom, L., Di Nicoal, V. F., Phil, M., et al (1985) Is there an obsessive psychosis? Aetiological and prognostic factors of an atypical form of obsessive-compulsive neurosis. Canadian Journal of Psychiatry, 30, 372379.
World Health Organization (1992) International Classification of Diseases and Related Health Problems, Tenth Revision (ICD–10). Geneva: WHO.
Recommend this journal

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

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 54 *
Loading metrics...

Abstract views

Total abstract views: 372 *
Loading metrics...

* Views captured on Cambridge Core between 3rd January 2018 - 21st April 2018. This data will be updated every 24 hours.

Obsessive-compulsive disorder and delusions revisited

  • Anne-Marie O'Dwyer (a1) and Isaac Marks (a1)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *