Features of obsessive–compulsive disorder in patients primarily diagnosed with schizophrenia

Abstract

We investigated the prevalence of obsessive-compulsive disorder (OCD) among patients who were primarily diagnosed with schizophrenia. We investigated the differences in the neuropsychiatric features and motor symptoms between patients with schizophrenia who did or did not have OCD. Seventy-one subjects with the DSM-IV diagnosis of schizophrenia were evaluated by the Structured Clinical Interview for DSM-IV Axis I Disorders, the Yale-Brown Obsessivecompulsive Scale and the Positive and Negative Syndrome Scale. To assess their motor symptoms, the Abnormal Involuntary Movements Scale, the Barnes rating scale for drug-induced akathisia and the Simpson and Angus extrapyramidal symptoms (EPS) rating scale were used. The 13 subjects with OCD (18.3%) had significantly more severe motor symptoms than the non-OCD subjects. Patients with schizophrenia who exhibit moderate to severe motor symptoms as sideeffects of neuroleptics, should be examined for OCD comorbidity. Patients who are found to have OCD comorbidity must be treated with carefully chosen medications, including serotonin reuptake inhibitors.

Dimensions of Psychosis in Patients with Bipolar Mania as Measured by the Positive and Negative Syndrome Scale

“…The scale has since become a widely used symptom assessment tool that is used to measure symptoms of psychosis in studies of schizophrenia, but also schizoaffective disorder [19] , bipolar disorder [12,13] , dementia [20] , post-traumatic stress disorder [21] , and obsessive compulsive disorder [22] .…”

Anxiety disorders and schizophrenia

“…In a group of 71 schizophrenia subjects, Ohta et al [15] demonstrated that the 13 subjects who also met criteria for OCD exhibited significantly more severe motor symptoms on extrapyramidal symptom rating scales than the non-OCD subjects. Comparing clinical characteristics and comorbidity, schizophrenia patients with OCD (n=55) scored lower in positive symptoms domains (as measured by the Scales for the Assessment of Positive and Negative Symptoms), more often received serotonin reuptake inhibitor augmentation or clozapine, and had more OCD-spectrum disorders (eg, body dysmorphic disorder and chronic tic disorder) than schizophrenia patients without OCD (n=55) [16].…”

Neuropsychological profile of schizophrenia with and without obsessive compulsive disorder

“…More than one-third of subjects with schizophrenia have OCS (Bland et al, 1987;Berman et al,1995;Bermanzohn et al, 2000) and 10-20% meet the diagnostic criteria for OCD (Eisen et al, 1997;Kruger et al, 2000;Nechmad et al, 2003;Ohta et al, 2003;Poyurovsky et al, 1999;Tibbo et al, 2000). Given such a high rate of co-morbidity, it has been hypothesized that the presence of OCD may represent a distinct subtype of schizophrenia.…”

“…It has been reported that schizo-obsessive disorder patients have greater neurological soft signs scores (Sevincok et al, 2004) and subtle motor abnormalities (Tibbo et al, 2000) and extrapyramidal symptoms (Kruger et al, 2000;Mukhopadhaya et al, 2009;Ohta et al, 2003) compared to schizophrenia patients, though a few studies found no more neurological soft signs or motor symptoms in patients with schizo-obsessive disorder (Poyurovsky et al, 2007). Schizoobsessive disorder has aslo been asscoiated with reduced volumes in the left hippocampus, frontal lobes (Aoyama et al, 2000) and anterior horn of the lateral and third ventricle (Goldstein et al, 1999).…”