Schizophrenia with and without obsessive-compulsive symptoms: a comparative analysis of performance on trail making test and disability on WHODAS

Abstract

BackgroundPresence of obsessive-compulsive symptoms (OCS) affects performance on tests of some cognitive functions, such as the trail making test (TMT), and may affect the level of disability in schizophrenia (SZ).AimsThe aim of the present study was to compare performance on TMT and disability on WHO Disability Assessment Schedule (WHODAS) in persons with SZ with and without OCS in a cross-sectional study.MethodsPersons with SZ (n=200) fulfilling DSM-V (Diagnostic and Statistical Manual) diagnostic criteria were assessed on Yale Brown Obsessive Compulsive Scale (YBOCS) and divided into two groups based on presence or absence of OCS. TMT and WHODAS V.2.0 were applied. The two groups as a whole, as well as a subsample matched on age, gender and age of onset were compared.ResultsOut of 200 persons with SZ, 37 (18.5%) reported OCS. The OCS group took a significantly longer mean time to complete TMT-A (Z=−3.02, p=0.003) as well as TMT-B (Z=-3.551, p<0.001). Significant correlations were found between TMT-A and total YBOCS Scores (r=0.351, p=0.033), as well as TMT-A and YBOCS compulsion scores (r=0.404, p=0.013) but not with TMT-B Scores. The OCS group reported greater disability in all domains separately as well as on average WHODAS Scores (Z=−5.969, p<0.001). Significant correlations were found between YBOCS obsession scores and YBOCS total scores with average WHODAS Scores (r=0.614, p<0.001 and r=0.406, p=0.013, respectively). We obtained essentially similar results with the matched subsample as well as with the entire group.ConclusionPersons with SZ and comorbid OCS had significantly poorer performance on TMTs and greater disability in comparison to persons with SZ alone. Magnitude of disability correlated with severity of OCS.

How Obsessive-Compulsive Symptoms Correlate with other Symptoms and Quality of Life in Schizophrenia? A Cross-Sectional Study

“…1,25 Moreover, patients with schizophrenia and OCS seem to have more severe psychotic and depressive symptoms and lower social functioning and disability. 11,27,32,33 However, some recent studies have suggested that the impact of schizophrenia may vary depending on the stage of schizophrenia, with early schizophrenia having a shielding effect and chronic schizophrenia having a deleterious effect. 34 In this study, delusions and OCS were found to have a positive correlation, supporting the view that these reflect a manifestation of over-valued ideas lying on a continuum of obsessional doubts to delusional certainty, suggesting a common underlying mechanism that may be related to a decreased capacity to inhibit behaviors or thoughts.…”

“… 1 , 25 Moreover, patients with schizophrenia and OCS seem to have more severe psychotic and depressive symptoms and lower social functioning and disability. 11 , 27 , 32 , 33 However, some recent studies have suggested that the impact of schizophrenia may vary depending on the stage of schizophrenia, with early schizophrenia having a shielding effect and chronic schizophrenia having a deleterious effect. 34 …”

The optimum parameters and neuroimaging mechanism of repetitive transcranial magnetic stimulation to post-stroke cognitive impairment, a protocol of an orthogonally-designed randomized controlled trial

“…The trail marking test (TMT) was firstly used in 1944 for America army individual intelligence assessment [ 22 ]. Nowadays, it is widely employed as a diagnostic tool for visual attention and executive functioning and the processing speed for neuropsychological diseases [ 23 , 24 ]. It consists of two parts in which the subject is instructed to connect a set of 25 circles containing numbers (Part A) or numbers and letters (Part B) arrayed pseudorandomly on a letter-size sheet of paper as fast as possible while still maintaining accuracy.…”

Comparing conventional treatment, single-target rTMS, or dual-target rTMS for the treatment of post-stroke cognitive impairment — clinical effects and neuroscientific insights: study protocol for a randomized controlled trial

“…The scoring criteria are the time taken to complete TMT-A and TMT-B, as well as the interference amount (TMT-B time consumption minus TMT-A time consumption) [ 17 ]. This tool is commonly used for diagnosing visual attention, executive function, and processing speed in neuropsychological diseases [ 18 , 19 ]. ADL.…”