Early Onset Schizophrenia Associated With Obsessive-Compulsive Disorder: Clinical Features and Correlates

Baytunca, Burak; Kalyoncu, Tuğba; Ozel, Ismail; Erermiş, Serpil; Kayahan, Bülent; Öngür, Döst

doi:10.1097/wnf.0000000000000248

Cited by 14 publications

(7 citation statements)

References 21 publications

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“…The higher treatment doses of clozapine in the OCD group replicates previous findings (Baytunca et al, 2017, Fernandez-Egea et al, 2018) and remained consistent in confirmatory multilinear regression analysis. This could have various explanations such as biological sex, where males require higher doses, and smoking status, where smokers require higher doses.…”

Section: Discussionsupporting

confidence: 88%

A cross sectional study of impact and clinical risk factors of antipsychotic-induced OCD

Biria

Huang

Worbe

et al. 2019

European Neuropsychopharmacology

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A large proportion of schizophrenia patients treated with second generation antipsychotics will develop Obsessive Compulsive Disorder (OCD). However, there are few studies about the impact of this comorbidity and who is at higher risk. In this study of clozapine-treated patients, we aimed to determine the impact on outcome of clozapine-induced OCD, as well as the clinical and sociodemographic risk factors related to OCD-onset in clozapine patients. We had strict and novel inclusion criteria to minimise mis-identification of cases. The Obsessive-Compulsive Inventory-Revised (OCI-R) was used to divide 231 clozapine-treated patients into extreme cases of OCD (OCI  ≥ 24 or checking subscale ≥6) versus non-OCD (OCI <15 and checking subscale <4). The Global Assessment of Functioning (GAF), short version of Warwick-Edinburgh Wellbeing scale and Clinical Global Impression for schizophrenia (CGI) scales were used to determine outcome. Socio-demographic information was used to identify the risk factors for OCD development. We found that schizophrenia patients with OCD symptoms had a significantly lower patient rated wellbeing scores ( p < 0.001) only (no difference in clinician rated wellbeing scores), higher CGI positive ( p < 0.01) and higher CGI depressive scores ( p < 0.05). The only risk factors that reached significance level were higher treatment dose ( p < 0.01) and younger paternal age at birth ( p < 0.05). There is scope for future studies based on e.g. imaging and genetic studies to further investigate causality, and in improving clinician screening for OCD.

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Section: Discussionsupporting

confidence: 88%

A cross sectional study of impact and clinical risk factors of antipsychotic-induced OCD

Biria

Huang

Worbe

et al. 2019

European Neuropsychopharmacology

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“…The change in insight in delusions has not been systematically investigated. Given the variability of insight between obsessions and delusions, it is understood that insight does not constitute a reliable basis for discrimination (Sa et al, 2009) Some authors suggested that the coexistence of schizophrenia and OCD reflects a different psychopathology and suggested the definition of schizo-obsessive subtype to this different group (Baytunca et al, 2017;Kazhungil et al, 2017;Meier et al, 2014). Poyurovsky et al (2004) defined the spectrum of schizoobsession, and stated that the concept of obsessive psychosis would be appropriate for patients with coexistence.…”

mentioning

confidence: 99%

“…Some researchers have suggested that the presence of some overlapping symptoms in OCD and schizophrenia may be due to the similarities in neurological circuits, anatomical structures, and neurotransmitters shown for each disorder (Baek et al, 2020). Reports of psychotic-themed obsessions in schizophrenic patients further complicate the clinical distinction (Baytunca et al, 2017).…”

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confidence: 99%

Comparative Clinical and Neuropsychological Characteristics in Schizophrenia and Schizophrenia–Obsessive-Compulsive Disorder Patients

Temircan¹,

Demirtaş

2021

J Nerv Ment Dis

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The present study aimed to compare neuropsychological characteristics of patients with schizophrenia and patients with schizophrenia-obsessive-compulsive disorder (OCD). A total of 78 patients were included in the study, with 32 patients diagnosed with schizophrenia and 46 patients diagnosed with schizophrenia-OCD according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria. Two groups of the patients were compared with each other in terms of demographic data, psychotic symptoms, and clinical and neuropsychological characteristics. In this study, the schizophrenia-OCD relationship was seen at a higher rate in male patients, and this group has worse clinical features. In addition, there was no significant difference among sociodemographics, clinical characteristics, and social and neuropsychological functionality between the two groups. According to our results, patients with schizophrenia-OCD experience more depression and anxiety that are related to poorer quality of life. Longitudinal and more homogeneous patient groups are needed for further studies to reveal whether schizophrenia accompanied by OCD is a comorbidity, a subtype of schizophrenia, or a different disorder.

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“…Comorbid schizophrenia-OCD (schizo-OCD) is characterized by the concurrent presentation of psychotic and obsessive-compulsive symptoms (86,(88)(89)(90), that may require high antipsychotic dosages for its acute exacerbations and for the maintenance of reduction of the severity of psychosis (91). Schizo-OCD sufferers show a distinct ERP pattern, with abnormally increased target activation similar to that described in OCD (20) but different from that usually observed in schizophrenia (76).…”

Section: P300 In Ocd Overlapping With Other Disordersmentioning

confidence: 99%

A Review on P300 in Obsessive-Compulsive Disorder

2021

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Neuropsychological studies indicate the presence of cognitive changes in patients with obsessive-compulsive disorder (OCD). Indeed, OCD may be included among the dysfunctions of the frontal lobes and their connections with the limbic system, associative cortex, and basal ganglia. P300 is a positive component of the human event-related potential (ERP); it is associated with processes of encoding, identification, and categorization constituting, as a whole, the superior cortical function of information processing. Thus, P300 explores several areas that are implicated in OCD pathophysiology. Our aim is to review all relevant studies on the P300 component of the human ERP in order to recognize any significant central nervous system (CNS) correlate of cognitive dysfunction in OCD. A PubMed-based literature search resulted in 35 articles assessing P300 in OCD and reporting neurophysiological correlates of response inhibition, cortical hyperarousal, and over-focused attention. A decreased P300 amplitude was reported in both adult and pediatric patients, with a trend toward normalization after pharmacological treatment. Source localization studies disclosed an association between P300 abnormalities and the functioning of brain regions involved in the pathophysiology of OCD. Moreover, studies converge on the evidence of neurophysiological dysfunction in the frontal areas with impairment of the normal inhibitory processes in OCD. At least some of these electrophysiological correlates might reflect the obsessive thoughts and compulsions that characterize this disorder. These findings may also support cognitive-behavioral therapy (CBT) approaches on over-focused attention and inflexibility of compulsive behaviors, which should be associated to pharmacological treatment in these patients.

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Early Onset Schizophrenia Associated With Obsessive-Compulsive Disorder: Clinical Features and Correlates

Cited by 14 publications

References 21 publications

A cross sectional study of impact and clinical risk factors of antipsychotic-induced OCD

A cross sectional study of impact and clinical risk factors of antipsychotic-induced OCD

Comparative Clinical and Neuropsychological Characteristics in Schizophrenia and Schizophrenia–Obsessive-Compulsive Disorder Patients

A Review on P300 in Obsessive-Compulsive Disorder

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