Nurhan FISTIKCI, Serkut BULUT, Volkan TOPÇUOĞLU

İçgörüsü az olan obsesif-kompulsif bozukluk

Obsesif kompulsif bozukluk ileri derecede yeti yitimine neden olabilen ruhsal bir bozukluktur. OKB hastalarında içgörü hastalığın ilk tanımlanmasından bu yana tartışma konusudur. Önceleri, nörotik bozukluklardan biri olarak kabul edilen obsesif kompulsif bozuklukta hastaların belirtilerini tama- men saçma ve abartılı bulmaları gerektiği düşünülmüştür. Ancak, obsesyonların ve kompulsiyonla- rın her zaman egodistonik bulunacağı fikri giderek değişmiştir. İlk olarak Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabının 4. Baskısında (DSM-IV)te obsesif kompulsif bozuklukta içgörüsü az olan ifadesine yer verilmiştir. İçgörüsü az olan ya da olmayan obsesif kompulsif bozukluğun içgörünün korunduğu obsesif kompulsif bozukluktan sosyodemografik, klinik ve tedavi özellikleri bakımından farklılıkları olabilir. Obsesif kompulsif bozuklukta belirti tiplerine göre içgörü düzeyleri değişebilmektedir. İçgörüsü az obsesif kompulsif bozukluk, obsesif kompulsif bozukluğun şiddetli bir formu ya da farklı özellikler gösteren bir alt tip olabilir. DSM-5 ile birlikte içgörü belirteci sınıflan- dırmadan çıkarılmıştır. Obsesif kompulsif bozukluk hastalarının içgörülerinin bir yelpaze ya da süreklilik şeklinde ele alınması gerekir.

Obsessive-compulsive disorder with poor insight

Obsessive-compulsive disorder is a mental disorder that may cause severe disability. Insight in obsessive-compulsive disorder has been an issue of debate since the disorder was described for the first time. Formerly, obsessive-compulsive disorder was regarded as one of the neurotic disorders and patients were supposed to find their symptoms as totally senseless and exaggerated. However, the idea that obsessions have to be regarded egodystonic has changed recently. Firstly in the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV), the term "with poor insight was used as a specifier for obsessive-compulsive disorder. Obsessive-compulsive disorder with low or no insight may differ from obsessive-compulsive disorder with good insight in terms of sociodemographic, clinical and treatment features. Along with types of obsessions, the levels of insight are subject to change. Obsessive-compulsive disorder with poor insight can either be a subtype with different features or a severe form of Obsessive-compulsive disorder. Along with DSM- 5 insight in obsessive-compulsive disorder is no longer classified as absent or present. Insight in obsessive-compulsive disorder needs to be conceptualized as a spectrum or continuity.

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