Fixity of belief, perceptual aberration, and magical ideation in obsessive-compulsive disorder

Clinicians and researchers have pondered the intersection of obsessive-comp ulsive disorder (OCD) and psychosis. We examined the records of 395 individ uals seeking treatment for OCD and classified participants according to the ir most frequent or distressing obsession and compulsion. All participants completed measures of fixity of belief, perceptual distortions, magical ide ation, and psychotic symptoms. Results indicated that individuals who repor ted fear of harming self or others via overwhelming impulse or by mistake, and those with religious obsessions, had poorer insight and more perceptual distortions and magical ideation than did individuals with other types of obsessions. These results did not appear to reflect mere differences in OCD severity. Results are discussed in light of previous findings showing that psychotic-Re symptoms are associated with attenuated treatment outcome in OCD. More research is needed to assess the absolute magnitude of psychotic- like features in OCD patients with impulse/mistake and religious obsessions and to examine whether these features interfere with standard cognitive-be havioral therapy. (C) 2001 Elsevier Science Inc. All rights reserved.