BACKGROUND: The presence of overvalued ideas (OVI) in patients with obsessive-compulsive disorder (OCD) has been theoretically linked to poorer treatment outcome. However, to date there have not been any quantitative measures of overvalued ideas. Therefore, the relationship between OVI and outcome has been primarily hypothetical. Rudimentary assessments have been attempted by asking patients to rate their strength of belief from 1 to 10, clinically rating the fixity of beliefs from 1 to 5, and rating patients on item 11 (insight) on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The purpose of this study was to determine the relationship between OVI, degree of severity of OCD symptoms, and improvement. METHOD: Twenty patients with OCD participated in the study. All patients were treated with six days a week of 90 minutes of exposure and response prevention (ERP) and selective serotonin re-uptake inhibitors. No changes in medication were made during the course of treatment and all patients had been on their respective medications for at least three months prior to entering the study. Assessment scales consisted of the Overvalued Ideas Scale (OVIS), Y-BOCS, Beck Depression Inventory, and the Beck Anxiety Inventory. RESULTS: The results indicated that overvalued ideas did not necessarily correlate with severity of symptoms on the Y-BOCS. The higher the score on the OVIS, the less change on the Y-BOCS score. CONCLUSION: Overvalued ideas appear to be an important predictor of poor outcome.
Overvalued ideas scale; obsessive-compulsive disorder; OCD; prediction; treatment outcome
