Phenomenology of OCD: Lessons from a large multicenter study and implications for ICD-11
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This study aimed to investigate the phenomenology of obsessive-compulsive disorder (OCD), addressing specific questions about the nature of obsessions and compulsions, and to contribute to the World Health Organization's (WHO) revision of OCD diagnostic guidelines. Data from 1001 patients from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders were used. Patients were evaluated by trained clinicians using validated instruments, including the Dimensional Yale-Brown Obsessive-Compulsive Scale, the University of Sao Paulo Sensory Phenomena Scale, and the Brown Assessment of Beliefs Scale. The aims were to compare the types of sensory phenomena (SP, subjective experiences that precede or accompany compulsions) in OCD patients with and without tic disorders and to determine the frequency of mental compulsions, the co-occurrence of obsessions and compulsions, and the range of insight. SP were common in the whole sample, but patients with tic disorders were more likely to have physical sensations and urges only. Mental compulsions occurred in the majority of OCD patients. It was extremely rare for OCD patients to have obsessions without compulsions. A wide range of insight into OCD beliefs was observed, with a small subset presenting no insight. The data generated from this large sample will help practicing clinicians appreciate the full range of OCD symptoms and confirm prior studies in smaller samples the degree to which insight varies. These findings also support specific revisions to the WHO's diagnostic guidelines for OCD, such as describing sensory phenomena, mental compulsions and level of insight, so that the world-wide recognition of this disabling disorder is increased.
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A significant proportion of OCD patients, 60-70%, experience sensory phenomena consisting of aversive or uncomfortable sensations or perceptions that drive repetitive behaviors.
“a significant proportion of patients (60–70%) also experience sensory phenomena (SP) consisting of aversive or uncomfortable sensations or perceptions that drive repetitive behaviors (Table 2) [73–76].”
From Toward a neurocircuit-based taxonomy to guide treatment of obsessive-compulsive disorder (2021) · cites this paper as [76]
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- Authors
- Shavitt, R. G., de Mathis, M. A., Oki, F., Ferrao, Y. A., Fontenelle, L. F., Torres, A. R., Diniz, J. B., Costa, D. L. C., do Rosário, M. C., Hoexter, M. Q., Miguel, E. C., & Simpson, H. B.
- Affiliations
- Universidade de São Paulo (BR)
- Universidade Federal do Rio de Janeiro (BR)
- Universidade Estadual Paulista (Unesp) (BR)
- New York State Psychiatric Institute (US)
- Corresponding author
- Shavitt, Roseli G.
- ORCID
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2014-10
- Volume
- 57
- Pages
- 141-148
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC7326117
- OpenAlex
- W2138706516
- Cited by
- 76
- References
- 35
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 5 · 2023: 4 · 2022: 9 · 2021: 9 · 2020: 10 · 2019: 7 · 2018: 3 · 2017: 8 · 2016: 3 · 2015: 3
- FWCI
- 5.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Acervo Digital da Universidade Estadual Paulista (Universidade Estadual Paulista) (submittedVersion)
- UNESP Institutional Repository (São Paulo State University) (submittedVersion)
- UNIFESP Institutional Repository (Universidade Federal de São Paulo) (submittedVersion)
- Funders
- Yale University
- National Institute of Mental Health (K24MH091555, K24MH09155)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- obsessive-compulsive disorder, phenomenology, sensory phenomena, obsession, compulsive behavior, insight, tic disorders, ICD-11, diagnostic criteria, compulsive checking, compulsive washing
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Brazil, Child, Compulsive Behavior, Female, Humans, Male, Middle Aged, Obsessive Behavior, Obsessive-Compulsive Disorder, Personality Assessment, Psychiatric Status Rating Scales, Young Adult
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