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Obsessions and Delusions: Separate and Distinct, or Overlapping?

Published online by Cambridge University Press:  07 November 2014

Paul C. Bermanzohn ,
Linda Porto ,
Phyllis B. Arlow ,
Sylvia Axelrod ,
Roslyn Stronger ,
Jeannette Martino-beyer ,
Simcha Pollack  and
Samuel G. Siris
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Abstract

The convergence of obsessive and schizophrenic symptoms, particularly the blending of obsessional and delusional features into complex symptoms, calls for a clarification of the relationship between obsessions and delusions, which are usually thought of as separate and distinct, even opposite entities. This brief review is a preliminary attempt to assess some of the difficult issues raised by these phenomena.

We evaluate obsessions and delusions, and how they may overlap. A patient's degree of insight has been deemed a determining factor in distinguishing between these primary symptoms. However, our review of the literature shows that a definite distinction between obsessions and delusions cannot be made solely on the basis of insight.

Type
Feature Articles
Information
CNS Spectrums , Volume 2 , Issue 3: Schizophrenia & OCD: Convergence , March 1997 , pp. 58 - 61
Copyright
Copyright © Cambridge University Press 1997

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References

1.Bermanzohn, PC, Porto, L, Arlow, PB, et al.Are some neuroleptic refractory symptoms of schizophrenia really obsessions?CNS Spectrums. 1997;50–57.Google Scholar
2.Bleuler, E. Lehrbuch der Psychiatrie (Springer, Berlin, 1960) - cited in Ballerini and Stanghellini (1989). See reference 3., below.Google Scholar
3.Ballerini, A, Stanghellini, G. Phenomenological questions about obsession and delusion. Psychopathology. 1989;22:315–319.Google Scholar
4.Westphal, K. Ueber zwangvorstellungen. Arch Psychiatr Nervenkr. 1878;8:734–750.Google Scholar
5.Freud, S. Notes upon a case of obsessional neurosis (1909). In: Jones, E, ed. Collected Papers. New York, NY: Basic Books, 1959;3.Google Scholar
6.Lewis, A. Problems of obsessional illness. Proc R Soc Med. 1936;29:325–336.Google Scholar
7.Insel, TR, Akiskal, HS. OCD with psychotic features: A phenomenologic analysis. Am J Psychiatry. 1986;143:1527–1533.Google Scholar
8.Insel, TR. Phenomenology of obsessive compulsive disorder. J Clin Psychiatry. 1990;519(suppl 2):4–8.Google Scholar
9.Zohar, J. Schizophrenia with OCD symptoms: diagnostic issues and clinical implications. Presented at the 10th World Congress of Psychiatry; August 23–28, 1996; Madrid, Spain.Google Scholar
10.Eisen, JL, Rasmussen, SA. Obsessive compulsive disorder with psychotic features. J Clin Psychiatry. 1993;54:373–379.Google Scholar
11.Foa, EB, Kozak, MJ. DSM-IV field trial: obsessive-compulsive disorder. Am J Psychiatry. 1995;152:90–96.Google Scholar
12.Phillips, KA, McElroy, SL. Insight, overvalued ideation, and delusional thinking in body dysmorphic disorder: theoretical and treatment implications. J Nerv Ment Dis. 1993;181:699–702.Google Scholar
13.Hollander, E, Phillips, KA. Body image and experience disorders. In: Hollander, E, ed. Obsessive-Compulsive-Related Disorders. Washington, DC: American Psychiatric Press. 1993;17–48.Google Scholar
14.Kozak, MJ, Foa, EB. Obsessions, overvalued ideas, and delusions in obsessive-compulsive disorder. Behav Res Ther. 1994;32:343–353.Google Scholar
15.Foa, EB. Failure in treating obsessive compulsives. Behav Res Ther. 1979;17:169–176.CrossRefGoogle ScholarPubMed
16.Lelliott, PT, Noshirvani, HF, Basoglu, M, Marks, IM, Monteiro, WO. Obsessive compulsive beliefs and treatment outcome. Psychol Med. 1988;18:697–702.Google Scholar
17.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Washington, DC: American Psychiatric Association; 1994.Google Scholar
18.Spitzer, M. On defining delusions. Compr Psychiatry. 1990;31:377–397.Google Scholar
19.Jaspers, K; Hoenig, J, Hamilton, MW, Trans. General Psychopathology. Chicago, Ill: University of Chicago Press; 1972;95–96.Google Scholar
20.Kendler, KS, Glazer, WM, Morgenstern, H: Dimensions of delusional experience. Am J Psychiatry. 1983;140:466–469.Google Scholar
21.Ghaemi, SN, Pope, HG. Lack of insight in psychotic and affective disorders: a review of empirical studies. Harvard Rev Psychiatry. 1994;2:22–33.Google Scholar
22.David, AS. Insight and psychosis. Br J Psychiatry. 1990;156:798–828.Google Scholar
23.Carpenter, WT Jr, Strauss, JS, Bartko, JJ. Flexible system for the diagnosis of schizophrenia: report from the World Health Organization International Pilot Study of Schizophrenia. Science. 1973;182:1275–1278.Google Scholar
24.Markova, IS, Berrios, GE. The meaning of insight in clinical psychiatry. Brit J Psychiatry. 1992;60:850–860.Google Scholar
25.Amador, XF, Strauss, DH, Yale, SA, Gorman, JM. Awareness of illness in schizophrenia. Schizophrenia Bulletin. 1991;17:113–132.Google Scholar