"Brain Not Right" and "Lonely in a Crowd": Unveiling the Central Architecture of Psychopathology in Obsessive-Compulsive Disorder
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By
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Xu, Lianlian
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Wu, Yue
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Zhang, Lina
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Liu, Huanzhong
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Zhu, Shuangyue
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April 24, 2026
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Objective:
To investigate the interaction mechanism between obsessive-compulsive disorder (OCD) and psychotic-like symptoms using network analysis.
Key Findings:
- 'Brain not right' (SCL90) has the highest betweenness centrality, acting as a metacognitive mediator.
- 'Lonely in crowd' (SCL77) has the highest strength, maintaining network activation.
- Unusual thoughts (SCL68) and somatic concern (SCL87) serve as bridge nodes linking OCD symptoms to psychotic disturbances.
- Malignant loops such as 'obsessive interference – collapse of metacognitive evaluation' were identified.
Interpretation:
The findings suggest that the perception of brain dysfunction and feelings of loneliness are central to the complexity of OCD symptoms.
Limitations:
- The study is limited to a specific patient population and may not generalize to all OCD patients.
- Network analysis may not capture all nuances of symptom interactions.
Conclusion:
Addressing metacognitive beliefs and social isolation is crucial for preventing the deterioration of OCD symptoms, alongside traditional treatments.
