The Role of Obsessional Beliefs in Symptomatology, Insight, and Severity of Obsessive-compulsive Disorder: A Cross-sectional Study

Aim and background: Obsessive-compulsive disorder (OCD), a chronic and debilitating disorder, is a clinically heterogeneous condition with symptoms and insight.Different models have been developed to elucidate the complexity of OCD and how obsessive beliefs significantly contribute to the onset and psychological aspects of the disorder.Evaluating the association between these beliefs and symptoms and their severity can be very advantageous.This study was planned to determine the relationship between obsessive beliefs and different symptom dimensions and the severity of symptoms in OCD patients.Materials and methods: Design: A cross-sectional study conducted in a hospital setting.Sampling: Eighty patients with OCD were selected based on diagnostic criteria using International Classification of Diseases (ICDs)-10, employing purposive sampling.Tools: Patients were assessed using Obsessional Belief Questionnaire-44 (OBQ-44), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Dimensional Obsessive-Compulsive Scale (DOCS), and Scale to Assess Unawareness in Mental Disorder (SUMD).Results: In this study, the mean Y-BOCS score was 27.09, indicating moderate to severe symptoms.The most prominent OBQ subdomain was found to be the perfectionism/certainty (PC) domain, and among the DOCS category, category 1, i.e., contamination, was the most prominent dimension.The majority of participants (67.5%) had a good understanding of their illness.Pearson's correlation showed significant positive correlations between OBQ-RT and DOCS2, OBQ-PC and DOCS1 and DOCS4, and OBQ-ICT and DOCS3.Scale to Assess Unawareness in Mental Disorder scores were positively correlated with Y-BOCS scores and DOCS category 1, and there were negative correlations between SUMD and DOCS category 3, as well as OBQ-ICT scores.Conclusion: Based on the findings, we can say that the dysfunctional obsessional beliefs were associated with symptom dimensions somewhat specific to these dimensions, and strong obsessional beliefs are likely to lead to more severe symptoms. Clinical significance:The association between obsessive beliefs and different dimensions of symptoms, as well as the severity of OCD, has been thoroughly investigated, with the results offering essential insights into the complexity of OCD and serving as the basis for different treatment responses across various dimensions and therapy approaches.