Abstract
Motivation/Background: We aim at presenting a case that would circumscribe to the concept of schizo-obsessive disorder, in which the onset at the end of adolescence was with OC phenomenology, the negative symptoms appearing subsequently, while the productive perceptual and ideational area (auditory hallucinations and pseudohallucinations, next to the reference delusional ideation and Kandinsky Clerambault syndrome) developed at about one year and a half after social insulation. To be noticed that in residual phases, OC phenomenology acquires other connotations than those prior to schizophrenia onset, the patient never acquiring again a total insight on the disorder.
 Method: Computed EEG, psychiatric interview, psychodynamic interview, psychiatric and psychological monitoring of daily evolution under treatment, life map, heteroanamnesis, psychological tests, psychodynamic interpretations.
 Results: According to Poyurovsky’s guide, the case circumscribes to the diagnostic of schizo-obsessive disorder. When obsessions and compulsions were related to the content of delusional ideas and hallucinations, other typical rituals of obsessive-compulsive disorders appeared too, the patient considered sometimes irrational and excessive.
 Conclusions: Social degradation of the patient is dictated mainly by the negative dimension of schizophrenia, secondly by energy consumption in fulfilling the rituals and compulsions and last but not least by the mood change in depressive sense.
Highlights
Obsessions and compulsions become subject to a delusional elaboration during active phases of psychosis or obsessional symptoms are inseparable of psychotic symptoms. [3]
[5] We are discussing on an elaboration of the subjective “present”, an authentic insertion of the person in question in the given reality: the synthesis of the present is based on the act, behaviour in which the subject is engaged. [6]
The central aspect of the psychasthenia, which leads to obsessions, is considered to be the feeling of “incompletion and imperfection”
Summary
Obsessions and compulsions become subject to a delusional elaboration during active phases of psychosis or obsessional symptoms are inseparable of psychotic symptoms. In which the subject fears of something outside him, in obsession, the fear targets even the acts of the subject, there being the question of inner tension reported to what the patient himself does. In the classical concept of Pierre Janet on neuroses, within the psychasthenia concept, the author approached the obsessive-compulsive disorder, as being a perturbation in perception and synthesis of the time lived. [5] We are discussing on an elaboration of the subjective “present”, an authentic insertion of the person in question in the given reality: the synthesis of the present is based on the act, behaviour in which the subject is engaged. The ideas and involuntary drives appear very and frequently, dominating patient’s life. [7]
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