Abstract
The present study aims to analyze the clinical and socio-demographic characteristics of patients with obsessive-compulsive disorder (OCD) in comorbidity with schizotypal personality disorder (SPD), as well as the response rate to pharmacological treatments. OCD+SPD patients had a younger age at onset, a higher probability to have more severe obsessive-compulsive symptoms, a higher rate of schizophrenia spectrum disorders in their first-degree relatives, and a poorer insight compared to OCD patients. During the 3-year follow-up period, these patients showed a lower rate of recovery, thus requiring augmentation with different psychotropic medications, including low doses of antipsychotics. Our findings suggest that the comorbidity of OCD and SPD causes a poor treatment response, and a reduced probability to recover using standard pharmacological treatment strategies. Further investigations are needed to identify alternative strategies, including psychoeducation and cognitive behavioral therapy, to manage such frequent comorbidity in clinical practice.
Highlights
Obsessive-compulsive disorder (OCD) includes a wide range of symptoms and is often associated with other psychiatric disorders [1]
Patients were included in the study if they had the following inclusion criteria: 1) main diagnosis of obsessive-compulsive disorder (OCD) according to the DSM-IV and confirmed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) [24]; 2) age between 18 and 65 years; 3) a minimum duration of illness of 1 year; and 4) willingness to participate in the study
Patients with OCD+schizotypal personality disorder (SPD) showed a worse response to treatments and were less likely to recover from OCD, compared to OCD patients without SPD
Summary
Obsessive-compulsive disorder (OCD) includes a wide range of symptoms and is often associated with other psychiatric disorders [1]. Despite not being the most frequent one, schizotypal personality disorder (SPD) has a clinical relevance among Axis II disorders when in comorbidity with OCD, with a 5–50% rate of co-occurrence reported in the different studies [5,6,7,8,9]. This high range could be due to the different methodologies adopted in the various studies to evaluate the presence of SPD, such as the categorical vs dimensional. We carried out a prospective, naturalistic study with the following aims: a) to identify the clinical and socio-demographic characteristics of OCD+SPD patients, and b) to assess their response to standard pharmacological treatments, compared to OCD subjects without SPD
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