Am J Psychiatry 1986; 143:1527-1533
Copyright © 1986 by American Psychiatric Association
Obsessive-compulsive disorder with psychotic features: a phenomenologic analysis
TR Insel and HS Akiskal
The authors review the literature on obsessive-compulsive disorder and
present clinical vignettes to illustrate that delusions can arise in the
course of this illness. These delusions do not signify a schizophrenic
diagnosis but represent reactive affective or paranoid psychoses, which are
generally transient. Using a phenomenologic analysis of 23 patients, the
authors further argue that obsessive- compulsive disorder represents a
psychopathological spectrum varying along a continuum of insight. Patients
at the severe end of this spectrum are best described as having an
"obsessive-compulsive psychosis." The authors discuss the implications of
these considerations for DSM-III revisions.
