Compulsive Symptoms In Schizophrenia Research Articles

Prevalence and Pattern of Olanzapine Emergent Obsessive–Compulsive Symptoms: A Cross-sectional Study

Objective: Olanzapine is an atypical antipsychotic medication and known for metabolic side effects but olanzapine-induced obsessive–compulsive symptoms are another important behavioral side effects which are less studied and only a few case reports reported these side effects. This study aims to estimate the prevalence and pattern of olanzapine-induced obsessive–compulsive symptoms in schizophrenia and bipolar affective disorders (BPADs). Methods: Subjects were recruited from psychiatry outpatient department. Subjects with schizophrenia ( n = 41) and BPAD ( n = 18) taking olanzapine at least more than 6 months were evaluated for clinical profile and the presence of obsession and compulsion symptoms by means of Yale-Brown Obsessive–Compulsive Symptom (YBOCS) checklist scale and data were collected on the structured format. Results: Eighteen (30.5%) of the 59 patients met YBOCS checklist scale for both obsessive–compulsive symptoms among subjects with schizophrenia and BPAD subjects. The mean duration of olanzapine intake was 2 years and the mean dose of olanzapine was 12.5 ± 5.21 mg in obsessive–compulsive symptoms (OCSs) present subjects and the mean dose was 13.78 ± 5.21 mg in subjects not having OCSs. Contamination was the most common obsession and checking was the most common compulsion. Conclusions: These findings suggest that obsessive–compulsive symptoms occur in a substantial percentage of patients taking olanzapine in schizophrenia and BPAD and most of the subjects had more than one OCS.

Schizophrenia and OCD, association and treatment. Literature review

IntroductionWorldwide epidemiological studies estimate that around 1% of the world population suffers from schizophrenia and 2 to 3% from compulsive-obsessive disorder (OCD). Moreover, a significant percentage of schizophrenia patients present an OCD comorbidity.These statistics testify to a close relationship between the two pathologies, which sometimes causes difficulties in differentiating between the two diagnoses, complicated by the fact that many schizophrenia patients can suffer from obsessive and/or compulsive symptomatology similar to OCD.ObjectivesThis literature review aims to explore the frequency of association between schizophrenia and OCD and the administrated treatment through articles exploration.MethodsWe conducted a literature review about the association frequency between schizophrenia and OCD and the administrated treatment, which implies scientific literature exploration and selecting several articles treating this topic.For our review, keywords used to search in Scopus and PubMed were: “schizophrenia and OCD” and “schizophrenia and OCD treatment” found more than 1500 results between 1988 and 2022. With the application of exclusion criteria, we included approximately 40 recent articles treating the frequency of association between schizophrenia and OCD and administrated treatment.We organized These articles by counties, association frequency, and the administrated treatment.ResultsOur review of these articles and studies finds mostly a percentage between 10% to 30 % worldwide (countries from Asia, America, Africa, and Europe) of schizophrenia patients suffering also from OCD. The difficulty of diagnosis between schizophrenia and OCD, and the frequency of existence of obsessive and/or compulsive symptoms in schizophrenia remains one of the most relevant challenges for diagnosis and treatment in these countries.We also found that administrated treatment was commonly pharmacological with psychotherapy association sometimes.ConclusionsOur review explored the frequency of schizophrenia and OCD association and the administrated treatment. We found significant comorbidity between the two pathologies. With these findings, we may suggest systematic research for OCD with adapted scales in every schizophrenia case.Disclosure of InterestNone Declared

Abstract- Poster

Background:Obsessive compulsive symptoms in schizophrenia are well recognized but less researched entity.We report case of 18 year male with excessive thoughts presenting with talking to self, withdrawn behavior, suspiciousness.Case Presentation:An 18 year male brought by mother complaining of excessive thoughts regarding game designing since 1 year. Gradually phone usage was limited to videos and having noticed by father who intervened, he was experiencing sadness of mood, withdrawn behaviour, talking to self, irritability and decreased appetite. 15 days later, episode of self-harming behavior. As days passed by, thoughts were out of control and past incidents of school fights occurred as flashes of images. Since 2 months, mentions of persons observing him and thoughts put into head by classmates (Thought Insertion) with intentions of causing harm (Persecutory Delusions). On Mental status examination, decreased psychomotor activity, speech with increased reaction time and decreased tone, volume, tempo, irritable mood, inappropriate affect with Grade 3 insight.Discussion & Conclusion:Gross et al. found that many patients with chronic course of OCD described basic symptoms as thought insertion and difficulties in discriminating intentional modalities as part of obsessive–compulsive symptomatology.This case highlights symptom progression from one spectrum to another and need for early recognition of Schizo-obsessive disorder to prevent schizophrenia in future.

Obsessive-compulsive symptoms in schizophrenia: a review.

To review the available literature on obsessive-compulsive symptom (OCS)/obsessive-compulsive disorder (OCD) in patients with schizophrenia. Electronic searches were carried out to locate studies reporting various aspects of OCS/OCD in patients with schizophrenia. Available evidence suggests that prevalence of OCS/OCD in patients with schizophrenia is much higher than prevalence in general population and it is seen in all the stages of schizophrenia, starting from at risk mental state to chronic/stabilisation/deficit phases. Symptom profile of OCS/OCD in schizophrenia is similar to that seen in patients with OCD only. Presence of OCS/OCD is associated with higher severity of symptoms of schizophrenia and more negative outcome. At present there is very limited data on the efficacy/effectiveness of various pharmacological measures and psychological interventions, for management of OCS/OCD in patients with schizophrenia. There is some evidence pointing towards beneficial effect of certain antipsychotics, antidepressants and cognitive behaviour therapy. Management of OCS/OCD in patients with schizophrenia involves proper assessment. If the OCS/OCD is related to use of particular antipsychotic use, initial attempt must be made to reduce the dose of antipsychotics, however, if this is not effective, than addition of a selective serotonin reuptake inhibitor (SSRIs) must be considered. If the OCS/OCD is not related to the use of antipsychotic medication, than depending up on the severity of psychotic symptoms, addition of SSRIs must be considered. This review suggests that OCS/OCD is highly prevalent among patients with schizophrenia and there is limited good quality evidence to make any specific recommendations for management.

Obsessive compulsive symptoms in schizophrenia

Obsessive compulsive symptoms in schizophrenia

Obsessive–compulsive symptoms in schizophrenia: prevalence and associated factors in a Nigerian population

Objectives: The objectives of this study were to determine the prevalence of obsessive–compulsive symptoms (OCS) among subjects with schizophrenia and also to determine their associated factors.Methods: A cross-sectional study involving 232 patients with schizophrenia were recruited from a teaching hospital in Nigeria. Socio-demographic questionnaire, Obsessive–Compulsive Inventory, Positive and Negative Syndrome Scale and Suicidality module of the MINI International Neuropsychiatric Inventory were administered.Results: The prevalence of OCS was 54.3% among patients with schizophrenia, and washing symptom was the most common (51.7%). Patients with schizophrenia that had OCS had more severe psychopathologies and higher levels of suicidality. OCS among patients with schizophrenia were also associated with the use of second-generation antipsychotic medications.Conclusions: OCS are common in schizophrenia. Hence, there is a need for routine screening of patients with schizophrenia for OCS and then, manage them appropriately.

Differential effects of antipsychotic agents on obsessive–compulsive symptoms in schizophrenia: a longitudinal study

Indirect evidence supports the assumption that antiserotonergic second-generation antipsychotics (SGA) induce and aggravate obsessive-compulsive symptoms (OCS) in schizophrenia. However, multimodal studies assessing the long-term interaction of pharmacotherapy and psychopathology are missing. Over 12 months, we followed-up 75 schizophrenia patients who were classified into two groups according to antipsychotic treatment: clozapine or olanzapine (group I) versus aripiprazole or amisulpride (group II). We applied the Yale Brown Obsessive Compulsive Scale (YBOCS) and investigated between-group changes over time as the primary endpoint. Group I showed markedly higher YBOCS scores at both time points. Repeated measure analyses of variance (ANOVAs) revealed significant interaction effects of group and time (per protocol sample (PP): p=0.006). This was due to persistently high OCS severity within group I, and decreasing YBOCS scores within group II. OCS severity correlated significantly with the negative and general psychopathology subscales of the Positive and Negative Syndrome Scale (PANSS), as well as with depressive symptoms. The progressive differences in OCS severity between our groups support the assumption of differential pharmacodynamic effects on comorbid OCS in schizophrenia. Further studies should address the pathogenetic mechanism, define patients at risk and facilitate early detection as well as therapeutic interventions.

Antiserotonergic antipsychotics are associated with obsessive–compulsive symptoms in schizophrenia

Epidemiological investigations show that up to 30% of schizophrenic patients suffer from obsessive-compulsive symptoms (OCS) associated with negative impact on the general prognosis. It has been proposed that antiserotonergic second-generation antipsychotics (SGAs) might induce OCS, but investigations of large samples integrating psychopathology, neuropsychology and psychopharmacology are missing. We stratified 70 patients with schizophrenia according to their mode of antipsychotic treatment: clozapine and olanzapine (group I) compared with aripiprazole and amisulpride (group II). The groups were matched according to age, sex, educational levels and severity of the psychotic disorder (Positive and Negative Syndrome Scale). As the primary endpoint, we evaluated OCS severity (Yale-Brown Obsessive-Compulsive Scale). OCS were significantly more prevalent and severe in group I, in which OCS severity correlated with dosage of clozapine and duration of treatment. Pronounced cognitive deficits in group I were found in visuospatial perception and visual memory (Wechsler Adult Intelligence Scale-Revised block design, Rey-Osterrieth Complex Figure Test), impulse inhibition (go/no-go test), higher perseveration scores (Wisconsin Card Sorting Test) and reduced set-shift abilities (Trail Making Test Part B, Set-shift Task). These cognitive domains correlated with OCS severity. OCS in schizophrenia are associated with antiserotonergic SGA treatment, but longitudinal studies have to prove causality. Before starting treatment with antiserotonergic SGAs, specific neurocognitive domains should be evaluated, as visuospatial learning and impulse inhibition performance might allow early detection of OCS secondary to antipsychotic treatment in schizophrenia.

Relationship between psychotic and obsessive compulsive symptoms in schizophrenia

The presence of obsessive compulsive symptoms (OCSs) in schizophrenia was recognized as early as the first descriptions of the illness. Studies investigating the association between OCSs and schizophrenia have defined their co-occurrence in terms of co-morbidity and compared schizophrenia patients separated into groups according to whether they presented OCSs or not. However, most of these studies did not take both the complexity of the schizophrenia phenomenology and that of OCSs into account. The present research investigates the relationship between schizophrenia symptoms and OCSs using a correlational approach with a dimensional perspective in order to determine how the OCSs contribute to symptom expression in schizophrenia. Fifty nine schizophrenia patients were rated for schizophrenia symptoms (SAPS-SANS) and OCSs (Y-BOCS). Schizophrenia symptoms scores were collapsed into four dimensional scores and OCSs into for other dimensional scores. The latter were entered as explanatory variables to determine their associations with schizophrenia dimension scores using series of stepwise regression models. The results showed a strong positive relationship between Delusions and Obsessions consistent with the view that they reflect manifestations of the similar mechanisms. Similar results indicate an association between Auditory hallucinations and Compulsions also suggesting that they share common mechanisms. On the other hand, there were inverse relationships between Somatic Obsessions and Disorganization and between Hoarding/Collecting Compulsions and Delusions or Auditory hallucinations. These results may reflect that these OCSs have a protective effect against disorganization and psychotic symptoms respectively.

Prevalence of obsessive compulsive symptoms among patients with schizophrenia.

Background:Obsessive compulsive symptoms in schizophrenia are well recognized but are a less-researched entity. These symptoms have important implications for management and prognosis.Aim:To find out the prevalence of obsessive compulsive symptoms among patients with schizophrenia.Materials and Methods:A total of 90 hospitalized patients with schizophrenia diagnosed according to DCR of ICD-10 criteria were selected for the study. Padua inventory and Yale-Brown Obsessive Compulsive Scale were applied to find out the prevalence and nature of obsessive compulsive symptoms.Results:It was found that 10% of schizophrenic patients had obsessive compulsive symptoms.Conclusion:Obsessive compulsive symptoms are prevalent in patients with schizophrenia. The presence of comorbidity should be explored for adequate management.

Obsessive–compulsive symptoms in schizophrenia: prevalence, correlates and treatment

Literature from the turn of the 20th Century to the present suggests that obsessive–compulsive symptoms occur among persons with schizophrenia at rates that far exceed what is found among persons not suffering from psychoses. Less clear, however, is the significance of those symptoms. Are obsessive–compulsive symptoms, for instance, related to other aspects of schizophrenia or do they represent another isolated dimension of distress? To address this issue, a review of studies is presented that explores the relationships between obsessive–compulsive symptoms; positive, negative and depressive symptoms; psychosocial dysfunction; and neurocognitive deficits. Results are interpreted as indicating that obsessive–compulsive symptoms are linked with graver impairments in psychosocial function. Regarding the relationship between obsessive–compulsive symptoms and neurocognition, results from across a broad range of studies are equivocal. A review of studies of pharmacological treatments for obsessive–compulsive symptoms has also failed to produce consistent results. While some agents have been found to lead to improvement in obsessive–compulsive symptoms, other studies suggest that these medications may exacerbate those same symptoms. In general, it appears that, at best, there are currently few effective treatments. Directions for future research are reviewed. Recommendations include the development of tailored psychological and psychopharmacological interventions, and the implementation of longitudinal studies sensitive to the possibility that there are qualitatively distinct groups of patients with schizophrenia and obsessive–compulsive symptoms.

Atypical antipsychotics and obsessive compulsive symptoms in schizophenia: Literature review

Background:Atypical antipsychotics are actually the first-line treatment in schizophrenia. Obsessive–compulsive symptoms (OCS) are common in patients suffering from schizophrenia and seem to worsen prognosis. Whilst atypical antipsychotics can be a useful augmentation strategy in refractory Obsessive Compulsive Disorder (OCD), their efficacy in case of comorbid obsessive compulsive symptoms in schizophrenia remains unclear.Aims:The purpose of this literature review was to examine the relationships between atypical antipsychotics, Obsessive Compulsive Symptoms (OCS) in schizophrenia.Method:A systematic MEDLINE database was run using the following key-words: atypical antipsychotics, obsessive compulsive symptoms and schizophrenia (27 articles).Results:Clozapine, risperidone,olanzapine and quietiapine may induce or exacerbate OCS in patients with schizophrenia due to their anti-serotoninergic properties. There was no study with ziprazidone,aripiprazole nor amisulpiride. For schizophrenic patients with comorbid OCS, the first line strategy appears to be combination therapy with clomipramine or an Selective Serotoninergic Reuptake Inhibitors (SSRIs)(fluvoxamine, sertraline, fluoxetine) and an atypical antipsychotic. Moreover, in these cases, cognitive behavioural therapy should also be considered.Conclusions:Obsessive Compulsive symptoms and schizophrenia are an ongoing matter of debate in terms of comorbidity or constitution of a specific schizo-obsessive subtype. Nevertheless, according to the worsening prognosis of this phenomenon, combination therapy (atypical antipsychotics and SSRIs) remains the most relevant therapeutic approach. Moreover, cognitive behavioural therapy studies in this area are required.

Obsessive compulsive symptoms in schizophrenia: Frequency and clinical features

Objective Prior studies have evaluated the occurrence and clinical effects of obsessive–compulsive (OC) symptoms in schizophrenia with varied results. This study systematically assessed the frequency and clinical impact of OC symptoms among outpatients with schizophrenia and schizoaffective disorder. Method One hundred subjects with schizophrenia or schizoaffective disorder were evaluated with a 20-question detailed screen for the presence of OC symptoms. The severity of OC symptoms was assessed with the Yale Brown Obsessive–Compulsive Scale (Y-BOCS). Fifty-eight patients participated in subsequent assessments comparing schizophrenia severity (Positive and Negative Syndrome Scale) functional status (Social and Occupational Functioning Scale) and resource utilization (psychiatric hospitalization) of OC ( N=21) and non-OC ( N=37) patients. Results Thirty percent of patients exhibited two or more OC symptoms, and 19% had at least moderate OC symptoms (Y-BOCS score ≥ 16). Twenty-three percent met full DSM-IV criteria for OCD. There were no differences observed between the OC and non-OC groups on any of the clinical outcomes. OC symptoms were developed prior to the onset of schizophrenia in only 28% of patients. Conclusions Nearly one-third of patients exhibited clinically significant OC symptoms in this systematic, cross-sectional assessment. However, OC symptoms did not appear to impact the clinical outcome of patients. In most cases, OC symptoms began concurrently with or after the onset of the psychotic disorder. Studies are needed to define the relevance and pathological basis for the co-occurrence of OC symptoms in persons with schizophrenia.

Obsessive–compulsive symptoms in schizophrenia: associated clinical features, cognitive function and medication status

Objective To determine the prevalence and clinical significance of obsessive–compulsive (OC) symptoms among a group of stable outpatients with schizophrenia. Methods We studied 118 patients with schizophrenia from an urban clinic, characterized using clinical symptoms scales, including the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS), and neuropsychological testing. We categorized patients into three groups according to severity of OC symptoms and used multivariate linear regression and chi-square tests to compare groups on variables of interest. Results Only 10 patients (8.8%) had Y-BOCS scores greater than 16, a standard criterion for OCD studies. The patient group with the most OC symptoms (Y-BOCS scores >11) scored higher on the Hamilton Depression Scale, the positive symptoms subscale of the Positive and Negative Syndromes Scale (PANSS) and its delusions item, but not on any of the neuropsychological tests compared to the other two groups. Patients with most severe compulsive symptoms (but not OC symptoms together, or obsessions alone) were more likely to be treated with olanzapine or clozapine, atypical antipsychotic medications previously reported to induce or worsen OC symptoms. Conclusions Our results confirm previous findings that patients with schizophrenia and comorbid OC symptoms have more positive symptoms but not the suggestion that such patients are more cognitively impaired than their counterparts without OC symptoms. We suggest possible explanations for discrepancies in the literature, including differences in patient sampling and definition of comorbid OC symptoms. Finally, our data suggest that olanzapine and clozapine may produce or worsen compulsions in some patients; prospective studies need to address this possibility.

Obsessive-Compulsive Schizophrenia: A New Diagnostic Entity?

Back to table of contents Previous article Next article LetterFull AccessObsessive-Compulsive Schizophrenia: A New Diagnostic Entity?Ilya Reznik, M.D., Roberto Mester, M.D., , Moshe Kotler, M.D., , and Abraham Weizman, M.D., Ilya ReznikSearch for more papers by this author, M.D., Roberto MesterSearch for more papers by this author, M.D., Ness-Ziona Mental Health Center, Ness-Ziona, Israel, Moshe KotlerSearch for more papers by this author, M.D., Faculty of Health Sciences, Ben Gurion University of the Negev, Israel, and Abraham WeizmanSearch for more papers by this author, M.D., Felsenstein Medical Research Center, Petach Tikva, IsraelPublished Online:1 Feb 2001AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail SIR: We read with great interest the recent article of Hwang et al.1 in which the clinical and neuropsychiatric features of schizophrenic subjects with severe and persistent obsessive-compulsive (OC) symptoms were investigated. The findings of this study replicated a known fact that OC-schizophrenia patients have a worse clinical course, showing poor treatment response and greater impairment of functioning.2 The authors also revealed that OC-schizophrenia patients showed an atypical set of clinical and neuropsychological characteristics, consisting of a higher level of negative symptoms, worse overall psychopathology, and significantly more impaired performance on the Wisconsin Card Sorting Test, raising a possibility of greater prefrontal pathology.1Schizophrenia with concurrent OC symptoms is of great interest. The etiology of OC phenomena in schizophrenia remains unclear. There is significant overlap of the proposed functional circuits and dysfunction at the neurotransmitter level between OCD and schizophrenia, which may lead to co-expression of symptoms. The interactions are multiple and complex, especially in regard to the serotonin and dopamine systems.3 Today controversy centers on whether there is a continuum or overlap in psychopathology between these entities that some authors have called “schizo-obsessive disorder.”4 Within this type, several clinically discrete groups were described: OCD patients who become psychotic; schizophrenic patients with comorbid OCD; schizophrenic patients exhibiting OC symptoms; and patients with comorbid OCD and schizotypal personality disorder.5 Existence of these groups may explain the diversity in epidemiological data, clinical manifestations and course, outcomes of various treatments, and prognosis.5OCD in schizophrenic patients, at least in the early stages of the disease, may have a “protective” effect regarding some psychotic symptoms and may be responsible for a less virulent course of illness and a higher level of functioning.6 On the other hand, patients with “OC schizophrenia” tended to have a more chronic course, a greater frequency of social and occupational impairment, and a poor long-term outcome.1,2,6 Treatment with serotonin reuptake blockers, added to the neuroleptic, was found to be efficacious in the treatment of obsessions and compulsions and to improve overall schizophrenic symptoms.7Most recently Berman at al.,8 using neurocognitive testing, pointed out the lack of correlation between OC and positive and negative symptomatology in schizophrenia and concluded that OC symptoms may constitute a distinct cluster, separate from psychosis, in schizophrenia and may possibly indicate a distinct subtype of schizophrenia. Their report underscores the importance of the findings of Hwang et al.,1 which support this point of view, and gives an additional strong clinical-neuropsychological complement to establishing the borders of a new diagnostic entity within the OCD-schizophrenia spectrum category. This very interesting area warrants more systematic studies to delve into this question further.References1 Hwang MY, Morgan JE, Losconzcy MF: Clinical and neuropsychological profiles of obsessive-compulsive schizophrenia: a pilot study. J Neuropsychiatry Clin Neurosci 2000; 12:91–94Link, Google Scholar2 Fenton WS, McGlashan TH: The prognostic significance of obsessive compulsive symptoms in schizophrenia. Am J Psychiatry 1986; 143:437–441Crossref, Medline, Google Scholar3 Tibbo P, Warneke L: Obsessive-compulsive disorder in schizophrenia: epidemiologic and biologic overlap. J Psychiatry Neurosci 1999; 24:15–24Medline, Google Scholar4 Zohar J: Is there room for a new diagnostic subtype: the schizo-obsessive subtype? CNS Spectrums 1997; 2:49–50Google Scholar5 Eisen JL, Phillips KA, Rasmussen SA: Obsessions and delusions: the relationship between obsessive-compulsive disorder and the psychotic disorders. Psychiatr Ann 1999: 29:515–522Google Scholar6 Poyurovsky M, Fuchs C, Weizman A: Obsessive-compulsive disorder in patients with first-episode schizophrenia. Am J Psychiatry 1999; 156:1998–2000Google Scholar7 Berman I, Sapers BL, Chang HH, et al: Treatment of obsessive-compulsive symptoms in schizophrenic patients with clomipramine. J Clin Psychopharmacol 1995; 15:206–210Crossref, Medline, Google Scholar8 Berman I, Merson A, Viegner B, et al: Obsessions and compulsions as a distinct cluster of symptoms in schizophrenia: a neuropsychological study. J Nerv Ment Dis 1998; 186:150–156Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited ByObsessive-Compulsive Disorder with Psychotic Features: Is It a Clinical Entity?29 September 2022 | Healthcare, Vol. 10, No. 10Psychiatry Research, Vol. 197, No. 3Síntomas obsesivo-compulsivos en pacientes con patologías del espectro esquizofrénico: frecuencia y relación con características clínicasRevista Colombiana de Psiquiatría, Vol. 40, No. 1Schizotypal traits, obsessive-compulsive symptoms, and social functioning in adolescentsComprehensive Psychiatry, Vol. 51, No. 1 Volume 13Issue 1 February 2001Pages 115-116 Metrics History Published online 1 February 2001 Published in print 1 February 2001

Olanzapine and obsessive–compulsive symptoms

Clozapine and risperidone have been implicated in the development of obsessive–compulsive symptoms. We present three cases in which olanzapine caused a significant exacerbation of obsessive–compulsive symptoms in schizophrenia (two cases) and obsessive–compulsive disorder (one case).

Obsessive and compulsive symptoms in schizophrenia: clinical and neurocognitive correlates.

Although research suggests that the presence of obsessive and compulsive symptoms in schizophrenia is associated with graver levels of psychosocial dysfunction, it is unclear whether it is also related to clinical features of illness. Accordingly, the present study compared the symptom levels and neurocognitive function of participants with schizophrenia who had and did not have significant obsessive or compulsive symptoms. Analyses of variance revealed that participants with significant levels of either obsessive or compulsive symptoms (N = 21) had higher levels of positive and emotional discomfort symptoms on the Positive and Negative Syndrome Scale (PANSS) and performed more poorly on the Wisconsin Card Sorting Test, a measure of executive function, than participants without obsessions or compulsions (N = 25). ANCOVAs controlling for level of obsessions also revealed that participants with significant levels of compulsions (N = 12) in particular had higher levels of negative and positive symptoms on the PANSS than participants without compulsions (N = 34). The impact of obsessive-compulsive phenomena on the course and outcome of schizophrenia is discussed.

Comorbidity in psychosis at first hospitalization.

The authors sought to determine the prevalence and effects of medical and psychiatric comorbidity on initial outcome in a group of patients experiencing a first episode of psychosis. Patients with a first episode of psychosis who were consecutively admitted to a hospital (N = 102) were examined for the presence of psychiatric and medical disorders. Patients were given psychiatric diagnoses with the use of the Structured Clinical Interview for DSM-III-R and were rated weekly on symptom rating scales. Outcome variables at discharge were final symptom rating scale scores, length of hospitalization, and recovery on the basis of operationalized criteria. Comorbid diagnoses were present in 52.0% (N = 53) of the patients, and 37.7% (N = 20) had multiple comorbid diagnoses. The most common comorbid diagnosis was substance abuse. Patients with affected psychoses were significantly more likely than those with nonaffective psychoses to have a comorbid substance abuse diagnosis. Patients with psychiatric comorbidity had poorer initial outcomes, while those with medical comorbidity had fewer symptoms at discharge. Comorbidity is common and may be a useful predictor of the outcome of a first episode of psychosis.

Prospective study of prodromal symptoms in schizophrenic relapse.

The authors examined the type and frequency of prodromal symptoms in 47 cases of schizophrenic relapse during which 30 patients were drug free and 17 were medicated. The findings indicate that clinicians who use patient and family reports can identify prodromal symptoms as they occur.

Transition of obsessions into delusions. Evaluation of obsessional phenomena from the prognostic standpoint.

Back to table of contents Previous article Next article ArticleNo AccessTRANSITION OF OBSESSIONS INTO DELUSIONSEvaluation of Obsessional Phenomena from the Prognostic StandpointALFRED GORDONALFRED GORDONSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.107.6.455AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByTreatment of co-occurring obsessive-compulsive and psychotic symptoms: A systematic reviewJournal of Obsessive-Compulsive and Related Disorders, Vol. 32Current Neuropharmacology, Vol. 17, No. 8History and Conceptual Problems of the Relationship Between Obsessions and HallucinationsHarvard Review of Psychiatry, Vol. 23, No. 1Obsessive–compulsive symptoms in schizophrenia: conceptual historyObsessive–compulsive symptoms in schizophrenia: psychopathological characteristicsOCD with poor insightComprehensive Psychiatry, Vol. 52, No. 4Expert Review of Neurotherapeutics, Vol. 9, No. 1Psychiatry Research, Vol. 141, No. 3Psychopathology, Vol. 39, No. 1Psychiatry and Clinical Neurosciences, Vol. 59, No. 3CNS Drugs, Vol. 18, No. 14The Relationship Between Obsessive-Compulsive Disorder and Psychosis16 November 2016 | Australasian Psychiatry, Vol. 10, No. 4Psychiatry Research, Vol. 102, No. 1Journal of Psychiatric Research, Vol. 34, No. 2Obsessions and Delusions: The Relationship Between Obsessive-Compulsive Disorder and the Psychotic DisordersPsychiatric Annals, Vol. 29, No. 9Obsessive-compulsive disorder in patients with schizophrenia or schizoaffective disorder1 April 2006 | American Journal of Psychiatry, Vol. 154, No. 2Behaviour Research and Therapy, Vol. 32, No. 3Obsessive-compulsive disorder with psychotic features: a phenomenologic analysis1 April 2006 | American Journal of Psychiatry, Vol. 143, No. 12Psychiatric Clinics of North America, Vol. 9, No. 1Obsessionality and Schizophrenia *26 April 2017 | Canadian Psychiatric Association Journal, Vol. 23, No. 2Acta Psychiatrica Scandinavica, Vol. 52, No. 5, Vol. 125The Psychiatric Quarterly, Vol. 40, No. 1-4British Journal of Psychiatry, Vol. 112, No. 488The Psychiatric Quarterly, Vol. 39, No. 1-4Acta Psychiatrica Scandinavica, Vol. 39, No. S177Journal of Mental Science, Vol. 103, No. 433Postgraduate Medical Journal, Vol. 29, No. 332 Volume 107Issue 6 December 1950Pages 455-458 Metrics PDF download History Published online 1 April 2006 Published in print 1 December 1950