Obsessive compulsive symptoms are associated with better functioning independently of cognition in schizophrenia

Kontis, Dimitrios; Theochari, Eirini; Nikolakopoulou, Mary; Andreopoulou, Angeliki; Vassos, Dimitrios; Grigoriou, V.; Vassilouli, Spyridoula; Giannakopoulou, Dimitra; Kouloumbi, Maria; Tsaltas, Eleftheria

doi:10.1016/j.comppsych.2016.06.009

Cited by 10 publications

(7 citation statements)

References 42 publications

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“…In fact, a categorical approach might not be appropriate to capture such dual relationship of PS impairment along a severity continuum of OC dimension. The finding of a direct association between severe OCS and PS scores (the "obsessive paradox") is in line with previous studies, which suggested a positive effect of comorbid OCS on specific cognitive functions (especially executive functions and working memory) either in patients with schizophrenia (Borkowska et al, 2003;Kontis et al, 2016;Lee et al, 2009) or in individuals with at-risk mental states for psychosis (Soyata et al, 2018;Zink et al, 2014).…”

Section: Discussionsupporting

confidence: 91%

“…However, whereas some studies found a specific pattern of cognitive impairment in OCS-comorbid patients (Michalopoulou et al, 2014;Patel et al, 2010;Schirmbeck et al, 2013), others failed to find significant differences with respect to non-OCS patients (Kazhungil et al, 2017). Some studies even reported a better performance in specific cognitive domains in the "schizo-obsessive" group (Kontis et al, 2016). The apparent inconsistency of results may be partly explained by the differences in the definition of diagnostic criteria for OCS, the heterogeneity of the neuropsychological tests used, or by a scarcely exhaustive neurocognitive assessment (Michalopoulu et al, 2014).…”

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confidence: 99%

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The “Obsessive Paradox”

Tonna¹,

Ottoni

Pellegrini

et al. 2019

J Nerv Ment Dis

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The objective of the study was to investigate the relationship between cognitive functions and obsessive-compulsive dimension in schizophrenia and a possible moderating effect of schizophrenia symptom dimensions on this association. Sixty-one schizophrenia patients were administered the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and the Matrics Consensus Cognitive Battery. A U-shaped curve described a gradual transition from an inverse association to a positive relationship between YBOCS and processing speed scores, along a severity gradient of obsessive dimension. This effect ("the obsessive paradox") was not moderated by other symptom dimensions. The present study suggests that severe obsessive-compulsive symptoms may participate to counterbalance processing speed impairment independently from other symptom dimensions. These results highlight the complexity of the relationship between cognitive and obsessive dimensions in schizophrenia.

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

The “Obsessive Paradox”

Tonna¹,

Ottoni

Pellegrini

et al. 2019

J Nerv Ment Dis

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“…Several findings have suggested a possible dual impact of OCS on functioning, with mild OCS being associated with better functioning and severe OCS with poorer functioning (de Haan et al, 2013;Tonna et al, 2016a, b). However, Kontis et al, (2016) found a positive association between OCS and social functioning, independent of cognitive functioning and the severity of OCS (Kontis et al, 2016). Other recent studies indicated a negative association with social and vocational functioning, even with relatively mild OCS severity (Schirmbeck et al, 2016b) or no associations (Grover et al, 2017).…”

Section: A C C E P T E D Mmentioning

confidence: 88%

Patterns of obsessive-compulsive symptoms and social functioning in schizophrenia; a replication study

Swets

Dijk

Schirmbeck

et al. 2019

Psychiatry Research

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“…As a variety of factors, among which the severity of OCS, might be at play, creating a dichotomy in people with and without OCS hampers the investigation of OCS severity and other moderating factors. Although some of the studies evaluated the association between dimensional measures [ 24 , 50 , 61 , 62 , 66 ], most used a categorical approach. Future studies should aim at using methods that allows to capture the complexity of this issue, for which a dimensional approach appears to be the most suitable option available.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of cognitive functioning in patients with psychotic disorders and obsessive–compulsive symptoms

Dijkstra

Vermeulen

Haan

et al. 2020

Eur Arch Psychiatry Clin Neurosci

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Obsessive-compulsive symptoms (OCS) in psychotic disorders are associated with unfavorable outcomes, whether this extends to cognitive function remains unclear. We conducted meta-analyses on several cognitive domains to investigate overall group differences between patients with a psychotic disorder and co-occurring OCS (OCS +) and those without OCS (OCS−). We used meta-regression to assess possible confounding effects. No overall associations between OCS + and OCS− in any of the 17 investigated cognitive domains were found. We predominantly found large heterogeneity in effect size and direction among studies. Post-hoc analyses of processing speed tasks not purely based on reaction-time showed worse performance in the OCS + group with a small effect size (SMD = − 0.190; p = 0.029). Meta-regression revealed advanced age was significantly correlated with worse performance of the OCS + group in processing speed (R 2 = 0.7), working memory (R 2 = 0.11), cognitive inhibition (R 2 = 0.59), and cognitive flexibility (R 2 = 0.34). Patients fulfilling the criteria for an obsessive-compulsive disorder showed less impairment in cognitive inhibition compared to the OCS + group (R 2 = 0.63). Overall, comorbid OCS were not associated with cognitive impairment. However, large heterogeneity between studies highlights the complex nature of factors influencing cognition in people with psychotic disorder and comorbid OCS and warrants further research into possible moderating factors.

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Obsessive compulsive symptoms are associated with better functioning independently of cognition in schizophrenia

Cited by 10 publications

References 42 publications

The “Obsessive Paradox”

The “Obsessive Paradox”

Patterns of obsessive-compulsive symptoms and social functioning in schizophrenia; a replication study

Meta-analysis of cognitive functioning in patients with psychotic disorders and obsessive–compulsive symptoms

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