Published online Feb 19, 2020. doi: 10.5498/wjp.v10.i2.12
Peer-review started: November 5, 2019
First decision: December 4, 2019
Revised: January 6, 2020
Accepted: January 13, 2020
Article in press: January 13, 2020
Published online: February 19, 2020
Obsessive-compulsive disorder (OCD) is a severe mental illness characterized by persistent, intrusive and distressing obsessions and/or compulsions. Such symptoms have been conceptualized as resulting from a failure in source-monitoring processes, suggesting that patients with OCD fail to distinguish actions they perform from those they just imagine doing. In this study, we aimed to provide an updated and exhaustive review of the literature examining the relationship between source-monitoring and OCD. A systematic search in the literature through January 2019 allowed us to identify 13 relevant publications investigating source-monitoring abilities in patients with OCD or participants with subclinical compulsive symptoms. Most of the retrieved studies did not report any source-monitoring deficits in clinical and subclinical subjects compared with healthy volunteers. However, most of the studies reported that patients with OCD and subclinical subjects displayed reduced confidence in source-monitoring judgments or global cognitive confidence compared to controls. The present review highlighted some methodological and statistical limitations. Consequently, further studies are needed to explore source monitoring with regard to the subcategories of OCD symptoms (i.e., symmetry-ordering, contamination-washing, hoarding, aggressive obsession-checking, sexual-religious thoughts) and to clarify the relationship between source-monitoring subtypes (i.e., reality or internal source-monitoring) and confidence in these populations.
Core tip: Symptoms of obsessive-compulsive disorder (OCD) have been proposed as resulting from a source-monitoring failure, suggesting that patients with OCD fail to distinguish actions they perform from those they just imagine doing. This study provides an updated and exhaustive review of the literature examining the relationship between source-monitoring performances and OCD. Most of the 13 retrieved studies did not report any source-monitoring deficits but reported reduced confidence in source-monitoring judgments in patients with OCD and subclinical subjects compared to controls. Furthermore, this review highlighted some methodological limitations and provided recommendations with respect to future studies focusing on source-monitoring in OCD.