Personality organization in patients with obsessive-compulsive disorder and its relationship with functionality

Abstract

Objectives: The aim of this study is to investigate the level of personality organization in obsessive-compulsive disorder (OCD), to determine the effect of personality organization dimensions on functioning, and to show the relation with insight important in DSM-5. Methods: One hundred patients with OCD diagnosed according to DSM-5 were included in the study. Yale Brown Obsessive-Compulsive Disorder Questionnaire (Y-BOCS), Personality Organization Diagnosis Form (PODF) and Global Assessment of Functioning (GAF) scales were administered to all participants. Correlation analysis was performed to test the relationship between total insight score and the PO dimensions with global functionality level in patients with OCD. Hierarchical linear regression models were conducted. After controlling other variables, the predictability of PODF components on global functionality was assessed. Results: In the neurotic personality spectrum of individuals with OCD 24%, 62% were in the spectrum of borderline personality organization, and 14% were in the spectrum of psychotic personality organization. Correlation analyses showed that the total GAF and Y-BOCS insight scores were positively correlated with the total score on the PODF mature defenses and the total PODF identity score, but negatively correlated with the total score from the PODF primitive defenses and the total PODF reality testing score. In the hierarchical regression model in which functionality was a dependent variable, the Y-BOCS insight score, the total score from PODF primitive defenses, and the total PODF reality testing score were inverse predictors of global functioning, and the total PODF score from mature defenses predicted global functioning in a linear direction. Discussion: It was concluded that dimensions of the PODF (with the exception of identity dimension) could be used to predict functionality, even if it was a confounding factor with insight. The variable of insight in OCD was a concept that differs from the reality-testing dimension. Assessing the level of personality organization in patients with OCD will help to create areas that can be remediated in the design of functionality and treatment plans.