OVERVALUED IDEAS, METACOGNITIONS, MAGICAL IDEATIONS, AND QUALITY OF LIFE IN OBSESSIVE–COMPULSIVE DISORDER
ABSTRACT
The importance of metacognitive processes is very important in the reinforcement of obsessive thoughts and compulsions in Obsessive Compulsive Disorder (OCD). In clinical practice, obsessions can sometimes be seen as Overvalued Ideas (OVI). In these patients, the obsessions are not delusional but lack insight. Magical thinking (MT), which are defined as a faulty causality relationship in the literature can also be seen in OCD. Presence of MT in OCD may affect the quality or quantity of obsessive symptoms. In this study, we aimed to assesment the association of OVI with metacognition and MT in OCD by comparing with controls and examining the impact of these clinical features on the severity of the OCD and the quality of life (QoL). For this purpose, 54 OCD and 55 control groups were included in the study. According to clinical interview and Yale-Brown Obsessive–Compulsive Scale (Y-BOCS) symptom list, patients were divided into two groups as autogenous (n:23) and reactive (n:31). Then Overvalued Ideas Scale (OVIS) was applied one-to-one by a same clinician to patients. All participants completed the Metacognitions Questionnaire-30 (MCQ-30), Magical Ideation Scale (MIS), World Health Organization Quality of Life Assessment-Bref-TR (WHOQOL-Bref-TR), Maudsley Obsessive–Compulsive Inventory (MOCI). In the results of the study, the WHOQOL-Bref-TR, MCQ-30 and MOCI total scores were significantly higher in the patient group compared to the control group; MIS total scores were found to be similar between the two groups. In addition; the QoL decreased as the MCQ-30 scores and the severity of MT increased in patients. OCD patients with autogenous and reactive obsessions were compared according to MCQ-30, WHOQOL-BREF, MOCI, Y-BOCS, MIS, and OVIS total and subscale scores. There was no statistically significant difference in the total MCQ-30 score between these two groups. While the OVIS scores of the patients with reactive obsessions were higher than the patients with autogenous obsessions, the "Uncontrollability and danger" subscale score of the MCQ-30 scale with autogenous obsessions was higher than the patients with reactive obsessions. Conclusion
High metacognition scores and severity of magical ideations indicate poor quality of life among OCD patients. Also, similar metacognitive pathologies in the OCD subtype groups support the thought of using Metacognitive Therapy as a treatment option with no consideration of the subtype.
Keywords: Obsessive–Compulsive Disorder; metacognition; overvalued idea; magical ideation; quality of life.
OBSESİF-KOMPULSİF BOZUKLUKTA AŞIRI DEĞERLENDİRİLMİŞ DÜŞÜNCELER, ÜSTBİLİŞLER, BÜYÜSEL DÜŞÜNCELER VE YAŞAM KALİTESİ
ÖZET
Obsesif Kompulsif Bozukluk (OKB) kişilerin yaşam kalitesini olumsuz etkileyerek yeti yitimine yol açan heterojen doğaya sahip bir bozukluktur. Hastaların obsesif düşüncelerinin ve kompulsiyonlarının sürdürülmesinde üst bilişsel süreçlerin önemi yadsınamaz. Klinik pratikte obsesyonlar zaman zaman Aşırı Değerlendirilmiş Düşünceler (ADD) olarak görülebilir. Bu hastalarda obsesyonlar sanrısal düzeyde olmasa da içgörüden yoksundur. Bununla birlikte literatürde hatalı nedensellik ilişkisi olarak tanımlanan, herhangi bir psikiyatrik rahatsızlığı bulunmayan kişilerde stres durumunda ortaya çıkabilen büyüsel düşünceler OKB hastalarında da görülebilmektedir. OKB hastalarında büyüsel düşüncelerin varlığı obsesif semptomların niteliğini veya niceliğini etkileyebilir. Tüm bu bilgiler ışığında bu çalışmadaki amacımız OKB hastalarında ADD’lerin varlığının, klinik özellikler, üstbilişsel süreçler, büyüsel inançlar ile ilişkisini değerlendirmek, bu parametreleri sağlıklı kontrol grubuyla kıyaslamak ve bu klinik özelliklerin hastalık şiddeti ve yaşam kalitesine olan etkisini incelemektir. Bu amaçla, ek ruhsal hastalığı olmayan 54 OKB ve 55 kontrol grubu çalışmaya dâhil e
Key words: Obsessive–Compulsive Disorder; metacognition; overvalued idea; magical ideation; quality of life.
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