Longitudinal association between motor and obsessive compulsive symptoms in patients with psychosis and their unaffected siblings

Lieuwe de Haan,Frederike Schirmbeck,Jack Dekker,Genetic Risk And Outcome Of Psychosis (Group) Investigators ,Marije Swets

doi:10.1007/s00406-018-0898-y

Abstract

Little is known about the co-prevalence of obsessive compulsive symptoms (OCS) and motor symptoms in patients with psychotic disorders. Cross-sectional associations between OCS and motor symptoms were assessed at baseline and at 3 years follow-up in patients (n = 726) with psychotic disorders and in their unaffected siblings (n = 761) from the Dutch Genetic Risk and Outcome of Psychosis (GROUP) study. Furthermore, longitudinal associations between changes in OCS and motor symptoms were evaluated. At baseline, OCS was not associated with any motor symptom (akathisia, dyskinesia, parkinsonism or dystonia) in patients. At follow-up, patients with OCS reported significantly more akathisia. Dividing the patients into four groups—no OCS, OCS remission with OCS only at baseline, OCS de novo with OCS only at follow-up and a persistent OCS group—revealed that the OCS de novo group already reported more akathisia at baseline compared to the no-OCS group. At follow-up, both the OCS de novo and the persistent OCS group reported more akathisia. These results remained significant after correcting for relevant confounders clozapine, GAF score, PANSS-negative score and IQ. Motor symptoms at baseline were significantly associated with OCS at follow-up, but not the other way around. In siblings, OCS at baseline was associated with akathisia, but this association was lost at follow-up. Results suggest that motor symptoms might precede co-occurring OCS in patients with psychotic disorders. However, no inference can be made about causality, and further prospective research is needed to investigate this assumption.

Highlights

Since the introduction of the DSM-III-R in the 1990s which allowed for comorbid diagnosis with schizophrenia, there has been an increasing research interest in the combination of psychosis and obsessive compulsive symptoms (OCS)
The aim of the current study is to evaluate if and to what extent, the presence of OCS in patients and in their unaffected siblings is associated with the presence of more various motor symptoms
We found no cross-sectional association between OCS and any motor symptoms at baseline, but we did find a cross-sectional association between OCS and akathisia and the composite motor score at follow-up

Summary

Introduction

Since the introduction of the DSM-III-R in the 1990s which allowed for comorbid diagnosis with schizophrenia, there has been an increasing research interest in the combination of psychosis and obsessive compulsive symptoms (OCS). Comorbid obsessive compulsive disorder (OCD) in schizophrenia is present in about 13.5% of cases [1, 43], roughly. Genetic Risk and Outcome of Psychosis (Group) Investigators are listed in the “Acknowledgements” section. The first description of motor symptoms, parkinsonism, akathisia, dyskinesia, catatonia and dystonia in schizophrenia dates back to over a century ago. Parkinsonism is a condition of tremor, motor rigidity and poverty of motion. Akathisia is a feeling of restlessness and an urgent need to move.

Methods

Results

Conclusion