The “Obsessive Paradox”

Abstract

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.

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

“…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.…”

The relationship between obsessive–compulsive symptoms and real-life functioning in schizophrenia: New insights from the multicenter study of the Italian Network for Research on Psychoses

“…It has been suggested that OCS and disorganization symptoms offset each other in their effect on executive function in nonclinical population [ 18 ]. In clinical population, there is evidence for a differential effect of OCS (improving or worsening according to a severity gradient) on specific cognitive domains in both patients with schizophrenia [ 19 , 20 ] and at-risk individuals [ 21 ]. Therefore, also for obsessive dimension, cognition might represent a crucial node, filtering the impact of OCS on functioning.…”