A qualititative study of neurological soft signs in obsessive compulsive disorder and effect of comorbid psychotic spectrum disorders and familiality on its expression in Indian population.

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Obsessive Compulsive Disorder (OCD) is one of the most common psychiatric disorders, with lifetime prevalence of 2%-3% and is known to lie on a spectrum continuous with Schizophrenia and other affective psychosis. Neurological Soft Signs (NSS) have been reported to be higher in both Schizophrenia and affective psychosis, like bipolar disorder, and their first degree relatives but in OCD, the results have been inconsistent. It remains unclear if NSS occur at even higher rates in individuals who have a co-morbidity for OCD and either schizophrenia or bipolar disorder, as it might be expected if a broader neurodevelopmental hit underlies the pathophysiology of both OCD and these disorders. To assess and compare NSS in patients of OCD, OCD with Psychotic spectrum disorders (OCD-PSD), first degree relatives of OCD (FDR of OCD) and healthy controls. 90 subjects each were recruited in four groups- OCD, OCD-PSD, FDR of OCD and healthy controls, as per the pre-defined inclusion and exclusion criteria for each group. Diagnosis was made as per ICD-10 criteria and Cambridge Neurological Inventory, Part-2 was applied. This study found statistically significant difference between the severity of NSS among these groups. There was also a significant difference in presence of NSS in OCD with PSD group and OCD group. A greater abnormality of NSS in FDR of OCD compared to healthy controls was found. This difference in proportions and severity of NSS between groups points towards an underlying common neurobiological and etiopathological underpinning between OCD with and without comorbid PSDs and their first degree relatives.