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학습 자료 둘러보기 →The hallmark of obsessive-compulsive disorder (OCD) is the presence of insight. The client recognizes that the obsessions and compulsions are excessive or unreasonable. This differentiates it from a delusional disorder where beliefs are held with strong conviction.
The DSM-5 describes a spectrum of insight: good or fair insight, poor insight, and absent insight/delusional beliefs. A client stating "I know it's excessive, but I can't stop" demonstrates intact insight, which is the most common presentation.
Do not confuse the ego-dystonic nature of OCD with psychosis. The presence of auditory hallucinations commanding the act or a complete, fixed belief that the ritual is rational indicates a need to evaluate for a primary psychotic disorder.
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