Thematic content of obsessive and compulsive symptoms and conversion to psychosis in a clinical high-risk cohort.

Abstract

We sought to explore the complex phenomenological overlap between obsessive and compulsive symptoms (OCS), and attenuated positive symptoms among 156 young people at clinical high-risk (CHR) for psychosis. In order to explore the hypothesis that OCS of an implausible nature might optimally predict future transition to syndromal psychosis, ideas associated with obsessive and compulsive experiences elicited by clinical measures were thematically categorized as "plausible" or "implausible." While OCS were found to be common in our CHR sample, we did not find that implausible OCS themes were predictive of conversion. Given the absence of qualitative differences between OCS and early psychotic symptoms, we propose that clinicians encountering adolescent or young adult patients with new-onset OCD or OCS in the past year should monitor such symptoms for a minimum of 2 years to assess for the possible emergence of psychosis.