Neurological soft signs in obsessive compulsive disorder with good and poor insight

ObjectiveObsessive compulsive disorder (OCD) is a clinically heterogeneous disorder; OCD with poor insight has been suggested to be a specific clinical subtype. Neurological soft signs (NSSs) may be helpful to identify the specific subtypes of OCD patients.MethodsIn the present study, we aimed to compare OCD patients with poor insight with OCD patients having good insight, and healthy individuals. Sixty-four OCD patients (38 with good insight and 26 with poor insight), and 32 healthy subjects were enrolled in the present study. The Overvalued Ideas Scale (OVIS) was used to determine OCD patients with poor insight. NSSs were assessed by using the Neurological Evaluation Scale (NES).ResultsTwo OCD groups had significantly higher total NES scores compared to controls (p = .000). Compared to healthy controls, OCD patients with poor insight performed significantly worse on all NES subscales, and they had significantly more NSSs on motor coordination, and sensory integration subscales compared to the OCD with good insight group.ConclusionOur results suggested that OCD patients with poor insight exhibit more extensive neurodevelopmental impairments compared to OCD patients with good insight.

Research highlights
► OCD patients with poor insight showed more neurological deficits especially on sensory integration.
► Two OCD groups had higher neurological soft signs than controls. Two OCD groups had similar impairment on complex motor movement and other subscales.
► Poor insight group had greater impairment than good insight group on motor coordination and sensory integration. OCD patients with poor insight exhibit more extensive neurodevelopmental impairments.