Presence Of Obsessive-compulsive Symptoms Research Articles

Influence of Clinical and Psychosocial Factors on the Adherence to Topical Treatment in Psoriasis.

(1) Background: Psoriasis is a common chronic inflammatory skin disease with different manifestations, affecting the quality of life at social, emotional, and professional dimensions and requiring long-term treatment. This study aimed to investigate the effect of psychosocial and clinical factors on adherence to topical treatment in psoriasis. (2) Methods: Self-reported measures and weighing the medicines were used to assess adherence. Psychopathological symptoms were measured using the Brief Symptoms Inventory (BSI). Social and clinical factors were assessed by a sociodemographic and clinical questionnaire. Adherence to treatment with topical medication was assessed using a sample of 102 psoriasis patients. (3) Results: The explanatory models of adherence to topical treatment in psoriasis translated into positive associations between adherence and the education level (higher education) (p = 0.03; φ = 0.23), the single-family household (p = 0.01; φ = 0.44), active employment status (p = 0.05; φ = -0.19), familiar history of psoriasis (p = 0.04; φ = -0.21), and the presence of obsessive-compulsive symptoms (p = 0.01; d = 0.29). (4) Conclusions: In patients who present the characteristics identified that influence non-adherence, instructions should be reinforced to increase adherence. The experimental mortality (39.6%) reduced the sample size, representing a limitation of the study.

Obsessive-compulsive symptoms in professional tennis players

IntroductionEngaging in moderate physical activity holds a vital role in our daily lives, serving as both a means of social recreation and a fundamental contributor to physical and mental wellbeing. It is also worth noting that such activity can potentially produce mood-enhancing effects by promoting neurogenesis and neuronal adaptability. Intriguingly, certain individual psychological traits such as rituals, compulsions, obsessional thinking, and superstitious beliefs, as well as inflexibility in daily routines, appear to serve a purpose in competitive athletic endeavors.ObjectivesThe aim of our study was to investigate the possible presence of obsessive-compulsive symptoms or disorders, as well as of superstitions or magical thinking, in a group of professional tennis players, by means of standardized assessment scales, as compared with healthy subjects who did not professionally perform any kind of sport activity.MethodsTwenty-five current or former professional tennis were recruited within the Italian Tennis Federation during an international competition and during a master meeting of coaches. All of them underwent a psychiatric interview with a structured scale and a psychopathological assessment carried out with the Mini-International Neuropsychiatric Interview (MINI) and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Data were analyzed and compared.analysis was performed by means of contingency tables, χ² tests, group statistics, paired, independent and Mann Whitney’s tests.ResultsThe Y-BOCS total score was significantly higher in both current and retired athletes than control subjects (5.96 ± 5.76 versus 1.24 ± 2.65, p = 0.001, t = 3.72). Current athletes showed more frequently current aggressive obsessions (χ2 = 0.041, r = 5.24) and current miscellaneous compulsions (χ2 = 0.030, r = 5.94) than past athletes. The Y-BOCS (t = 3.4, p = 0.002) obsessions (t = 3.48, p = 0.002), and compulsions subscale (t = 3.11, p = 0.005) scores were higher in current players than in the other group.ConclusionsOur results support the hypothesis that high-level competitive sports activities, which suppose compliance with strict daily routines and extensive training, could constitute a risk factor for the onset of full-blown obsessive-compulsive disorder in more vulnerable subjects. Similarly, there is a growing demand for sport psychological support experts in order to prevent high stress in training and competitions.Disclosure of InterestNone Declared

Concurrent Obsessive-Compulsive Symptoms in Patients With Schizophrenia: A Retrospective Study From a Tertiary Care Centre in Sindh, Pakistan.

The present study aimed to evaluate the proportion of concurrent symptoms of obsessive-compulsive symptoms (OCSs) among patients with schizophrenia. A retrospective study was undertaken at the Department of Psychiatry, Jinnah Postgraduate Medical Center, Sindh, Pakistan between 1st March 2019 and 1st April 2020.All cases with diagnosed schizophreniairrespective of gender, age, or ethnicity were eligible for the study. We excluded patients with acute psychosis due to isolatedsubstance use disorder or any organic brain disease. The medical records for each patient were retrieved from the departmental database. Sociodemographic factors including age, gender, ethnicity, and presence of OCSs and other psychiatric comorbidities were recorded in a predefined pro forma. The presence of OCSs was noted by the attending psychiatrist during history taking as positive or negative. A total of 139 patients were included. A predominance of the male gender was noted.There were 63 (45.3%) patients with concurrent OCSs. Out of the total patients, 42 (66.67%) males and 21 (33.33%) females had OCSs. A total of 28 (44.44%) patients between 31 and 45 years of age had OCSs. Out of the 63 patients with OCSs, 36 (57.14%) had a history of substance abuse (p = 0.471). In the study, 17 (26.98%) Balochi and 19 (30.16%) Pashtuns had OCSs. However, the difference was statistically insignificant. In conclusion, OCSs were frequent in patients with schizophrenia, according to the current study. We discovered that males, individuals between the ages of 18 and 30 years, Balochis, Pashtuns, and those with a history of substance abuse were more likely to have OCSs. However, the difference was not statistically significant.

Obsessive-compulsive symptoms in schizophrenia patients and their first-degree relatives and the association with subclinical psychotic symptoms

Objective This study aimed to investigate the presence of obsessive-compulsive symptoms (OCS) in patients being followed for schizophrenia and their first-degree relatives (mother, father, siblings, and children) and the relationship between OCS and clinical/subclinical psychotic symptoms. Materials and methods The study included 110 schizophrenia patients followed up in a community mental health center and their first-degree relatives. Patients and relatives were evaluated using the SCID-I (Structured Clinical Interview Form for DSM-IV Axis-I Disorders) to ascertain their diagnosis and exclude other axis-I diagnoses. The Yale-Brown Obsessive Compulsive Scale was used to measure OCS severity. Psychotic symptom severity was evaluated in patients using the Positive and Negative Syndrome Scale (PANSS) and subthreshold psychotic symptoms and psychosis proneness were assessed in relatives using the Schizotypal Personality Questionnaire. Results The prevalence of clinically significant OCS was 41.8% in schizophrenia patients and 28.2% in their relatives. PANSS positive and general psychopathology subscale scores were higher in patients with OCS. Suspiciousness and interpersonal schizotypy scores were significantly higher in relatives with OCS compared to those without. The first-degree relatives of patients with OCS did not exhibit a higher prevalence of OCS or psychotic symptoms compared to the relatives of patients without OCS. Conclusion Our study demonstrates that obsessive-compulsive phenomena are common in schizophrenia patients and their relatives. Although there seems to be a positive association between OCS and psychotic symptoms in patients and their first-degree relatives, the intergenerational transmission of these two symptom groups may occur independently.

Facing the “new normal”: How adjusting to the easing of COVID-19 lockdown restrictions exposes mental health inequalities

BackgroundRe-establishing societal norms in the wake of the COVID-19 pandemic will be important for restoring public mental health and psychosocial wellbeing as well as economic recovery. We investigated the impact on post-pandemic adjustment of a history of mental disorder, with particular reference to obsessive-compulsive (OC) symptoms or traits. MethodsThe study was pre-registered (Open Science Framework; https://osf.io/gs8j2/). Adult members of the public (n = 514) were surveyed between July and November 2020, to identify the extent to which they reported difficulties re-adjusting as lockdown conditions eased. All were assessed using validated scales to determine which demographic and mental health-related factors impacted adjustment. An exploratory analysis of a subgroup on an objective online test of cognitive inflexibility was also performed. ResultsAdjustment was related to a history of mental disorder and the presence of OC symptoms and traits, all acting indirectly and statistically-mediated via depression, anxiety and stress; and in the case of OC symptoms, also via COVID-related anxiety (all p < 0.001).One hundred and twenty-eight (25%) participants reported significant adjustment difficulties and were compared with those self-identifying as “good adjusters” (n = 231). This comparison revealed over-representation of those with a history or family history of mental disorder in the poor adjustment category (all p < 0.05). ‘Poor-adjusters’ additionally reported higher COVID-related anxiety, depression, anxiety and stress and OC symptoms and traits (all p < 0.05). Furthermore, history of mental disorder directly statistically mediated adjustment status (p < 0.01), whereas OC symptoms (not OC traits) acted indirectly via COVID-related anxiety (p < 0.001). Poor-adjusters also showed evidence of greater cognitive inflexibility on the intra-extra-dimensional set-shift task. ConclusionIndividuals with a history of mental disorder, OC symptoms and OC traits experienced greater difficulties adjusting after lockdown-release, largely statistically mediated by increased depression, anxiety, including COVID-related anxiety, and stress. The implications for clinical and public health policies and interventions are discussed.

Association Between Obsessive-Compulsive Symptom Dimensions in Mothers and Psychopathology in Their Children.

Background: The non-clinical presentation of obsessive–compulsive symptoms (OCS) in women may impact not only their daily lives and well-being but also increase the risk for emotional and behavioral problems in their children. This study aims to investigate the OCS dimension distribution in a large sample of mothers from a cohort of school age children and the association between these OCS dimensions with their own psychopathology, and with the presence of OCS and other psychopathology in their children.Method: Our final sample consisted of 2,511 mother-children dyads recruited from the elementary schools of two large cities. Throughout multiple regression analysis, we examined the correlations between demographic and clinical variables of mothers assessed by the Mini International Psychiatric Interview (MINI) and the Dimensional Yale-Brown Obsessive-Compulsive Scale-Short Version (DY-BOCS-SV) with children's psychopathology status reported by the Child Behavior Checklist (CBCL).Results: The overall prevalence of mothers who reported experiencing at least one OCS was 40% (N = 1,004). “Aggression/violence” was the most frequent symptom dimension (32.2%), followed by the “symmetry/ordering” (16.4%) and the “sexual/religious” dimensions (13.8%). There was a significant correlation between the presence of OCS and maternal psychopathology in general (p < 0.001, r = 0.397). Not only the presence but also the severity of the mother's OCS were strongly correlated to the total (p < 0.001), internalizing (p < 0.001), externalizing (p < 0.001), and OCS subscale scores (p < 0.001) on the CBCL.Conclusion: OCS dimensions are highly prevalent in women. Presence and severity of maternal OCS are related to children's psychopathology and behavioral problems.

Facing the 'New Normal': How Adjusting to the Easing of COVID-19 Lockdown Restrictions Exposes Mental Health Inequalities

Background: Re-establishing societal norms in the wake of the COVID-19 pandemic will be important for restoring public mental health and psychosocial wellbeing as well as economic recovery. We investigated the impact on post-pandemic adjustment of a history of mental disorder, with particular reference to obsessive-compulsive (OC) symptoms or traits.&amp;nbsp;&amp;nbsp; Methods: The study was pre-registered (Open Science Framework; https://osf.io/gs8j2/).&amp;nbsp;Adult members&amp;nbsp;of the public (n=514) were surveyed between July and November 2020, to identify the extent to which they reported difficulties re-adjusting as lockdown conditions eased. All were assessed using validated scales to determine which demographic and mental health-related factors impacted adjustment. An exploratory analysis of a subgroup on an objective online test of cognitive inflexibility was also performed.&amp;nbsp;&amp;nbsp; Results: Adjustment was related to a history of mental disorder and the presence of OC symptoms and traits, all acting indirectly and statistically-mediated via depression, anxiety and stress; and in the case of OC symptoms, also via COVID-related anxiety (all p&amp;lt; .001).&amp;nbsp;One hundred and twenty-eight (25%) participants reported significant adjustment difficulties and were compared with those self-identifying as &ldquo;good adjusters&rdquo; (n=231). This comparison revealed over-representation of those with a history or family history of mental disorder in the poor adjustment category (all p&amp;lt;.05). &lsquo;Poor-adjusters&rsquo; additionally reported higher COVID-related anxiety, depression, anxiety and stress and OC symptoms and traits (all p&amp;lt; .05). Furthermore, history of mental disorder directly statistically mediated adjustment status (p&amp;lt; .01), whereas OC symptoms (not OC traits) acted indirectly via COVID-related anxiety (p&amp;lt; .001). Poor-adjusters also showed evidence of greater cognitive inflexibility on the intra-extra-dimensional set-shift task.&amp;nbsp; Conclusion: Individuals with a history of mental disorder, OC symptoms and OC traits experienced greater difficulties adjusting after lockdown-release, largely statistically mediated by increased depression, anxiety, including COVID-related anxiety, and stress. The&amp;nbsp;implications for clinical and public health policies and interventions are discussed. Funding: None to declare. Declaration of Interest: Prof. Naomi A. Fineberg declares that in the past 3 years she has held research or networking grants from the ECNP, UK NIHR, EU H2020, MRC, University of Hertfordshire; she has accepted travel and/or hospitality expenses from the BAP, ECNP, RCPsych, CINP, International Forum of Mood and Anxiety Disorders, World Psychiatric Association, Indian Association for Biological Psychiatry, Sun; she has received payment from Taylor and Francis and Elsevier for editorial duties. In the past 3 years, she has accepted a paid speaking engagement in a webinar sponsored by Abbott. Previously, she has accepted paid speaking engagements in various industry supported symposia and has recruited patients for various industry-sponsored studies in the field of OCD treatment. She leads an NHS treatment service for OCD. She holds Board membership for various registered charities linked to OCD. She gives expert advice on psychopharmacology to the UK MHRA. Prof. Samuel R. Chamberlain declares that his role in this research was funded by a Wellcome Trust Clinical Fellowship (110049/Z/15/Z &amp;amp; 110049/Z/15/A). Prof. Chamberlain previously consulted for Promentis (past 3 years) and receives a stipend from Elsevier for editorial work. Dr. Luca Pellegrini, Dr. David Wellsted, Natalie Hall, Prof. Ornella Corazza, Valentina Giorgetti, Dorotea Cicconcelli, Elena Theofanous, Nick Sireau, David Adam, Prof. Keith R. Laws report no financial relationships with commercial interests. Ethical Approval: The protocol and study objectives were pre-registered on 15th July 2020 (Open Science Framework; doi:10.17605/OSF.IO/GS8J2). Ethics approval was granted from the University of Hertfordshire (Ethics number: aLMS/SF/UH/04219).

Evaluation of obsessive-compulsive symptoms in relation to smartphone use.

IntroductionThe use of smartphones throughout the United States continues to rise. Although smartphones have increased our capacity to access information, there is concern if excessive use may impact mental health. The purpose of this study was to examine whether a relationship exists between smartphone use and the presence of obsessive-compulsive symptoms (OCS) or behaviors.MethodsA 33-item online survey was developed with 19 items relating to Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria for obsessive-compulsive disorder (OCD). A survey response was considered positive for possible OCS if participants answered at least 3 questions as Most of the time or All of the time for the OCD-related questions structured around the DSM-5 criteria for OCD while also using their smartphone for greater than 2 or more hours per day.ResultsA total of 308 of 550 subjects identified spending 2 or more hours on their smartphone per day and also answered positively on 3 or more questions designed to identify OCS. A statistically significant difference was discovered between those who used their smartphone for 2 or more hours per day and those who met 3 or more positive criteria for OCS compared to those who used their smartphone less than 2 hours per day (P < .00001).DiscussionThe results of this study demonstrate a possible relationship between smartphone use and OCS. Additional research needs to be conducted to further investigate these results to determine their significance in clinical practice.

The Child Behavior Checklist-Obsessive-Compulsive Subscale Detects Severe Psychopathology and Behavioral Problems Among School-Aged Children.

The aims of this study were (1) to assess obsessive-compulsive symptoms (OCS) dimensionally in a school-aged community sample and to correlate them with clinical and demographical variables; (2) to determine a subgroup with significant OCS ("at-risk for OCD") using the Child Behavior Checklist (CBCL-OCS) and (3) to compare it with the rest of the sample; (4) To review the CBCL-OCS subscale properties as a screening tool for pediatric OCD. Data from the Brazilian High Risk Cohort were analyzed. The presence and severity of OCS were assessed through the CBCL-OCS subscale. DSM-IV psychiatric diagnoses were obtained by the Developmental and Well-Being Assessment. Behavioral problems were assessed using the Strengths and Difficulties Questionnaire, the Youth Strengths Inventory, and the CBCL internalizing and externalizing behavior subscales. A total of 2512 (mean age: 8.86 ± 1.84 years; 55.0% male) children were included. Moderate correlations were found between OCS severity and functional impairment (r = 0.36, p < 0.001). Children with higher levels of OCS had higher rates of psychiatric comorbidity and behavioral problems (p < 0.001). A score of 5 or higher in the CBCL-OCS scale determined an "at-risk for OCD" subgroup, comprising 9.7% of the sample (n = 244), with behavioral patterns and psychiatric comorbidities (e.g., tics [odds ratios, OR = 6.41, p < 0.001]), anxiety disorders grouped [OR = 3.68, p < 0.001] and depressive disorders [OR = 3.0, p < 0.001] very similar to those described in OCD. Sensitivity, specificity, positive predictive value, and negative predictive value of the CBCL-OCS for OCD diagnosis were, respectively, 48%, 91.5%; 15.1%, and 98.2%. The dimensional approach suggests that the presence of OCS in children is associated with higher rates of comorbidity, behavioral problems, and impairment. The "at-risk for OCD" group defined by the CBCL revealed a group of patients phenotypically similar to full blown OCD.

Obsessive Compulsive Symptoms/disorder in patients with schizophrenia: Prevalence, relationship with other symptom dimensions and impact on functioning

The aim of this study was to evaluate the prevalence of comorbid obsessive compulsive symptoms/disorder and its impact on outcome among patients with schizophrenia. 181 patients with schizophrenia were evaluated on Yale-Brown Obsessive–Compulsive Symptom Checklist, Yale-Brown Obsessive–Compulsive Scale, Calgary Depression Scale for Schizophrenia, Positive and Negative Symptom Scale, Social Occupational Functioning Scale, Global Assessment of Functioning Scale and Indian Disability Evaluation and Assessment Scale. Slightly more than one-fourth of patients fulfilled the diagnosis of current (28.2%) and lifetime (29.8%) diagnosis of obsessive compulsive disorder. On Yale Brown Obsessive Compulsive Symptom Checklist, the most common lifetime obsessions were those of contamination (25.4%), followed by obsessions of need for symmetry or exactness (11.6%). The most common compulsions were those of cleaning/washing (27.1%), followed by those of checking (24.3%). Presence of obsessive compulsive symptoms was associated with younger age of onset, higher prevalence of comorbid depression, and current suicidal ideations. Thus, it can be concluded that a significant proportion of patients with schizophrenia have obsessive compulsive symptoms/disorder. Clinicians managing patients of schizophrenia should evaluate the patients thoroughly for presence of comorbid obsessive compulsive symptoms/disorder and must take the same into account while managing the patients.

Schizo-obsessive spectrum disorders: an update.

The presence of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorders (OCD) in schizophrenia is frequent, and a new clinical entity has been proposed for those who show the dual diagnosis: the schizo-obsessive disorder. This review scrutinizes the literature across the main academic databases, and provides an update on different aspects of schizo-obsessive spectrum disorders, which include schizophrenia, schizotypal personality disorder (SPD) with OCD, OCD with poor insight, schizophrenia with OCS, and schizophrenia with OCD (schizo-obsessive disorder). An epidemiological discussion on the discrepancies observed in the prevalence of OCS and OCD in schizophrenia across time is provided, followed by an overview of the main clinical and phenomenological features of the disorder in comparison to the primary conditions under a spectral perspective. An updated and comparative analysis of the main genetic, neurobiological, neurocognitive, and pharmacological treatment aspects for the schizo-obsessive spectrum is provided, and a discussion on endophenotypic markers is introduced in order to better understand its substrate. There is sufficient evidence in the literature to demonstrate the clinical relevance of the schizo-obsessive spectrum, although little is known about the neurobiology, genetics, and neurocognitive aspects of these groups. The pharmacological treatment of these patients is still challenging, and efforts to search for possible specific endophenotypic markers would open new avenues in the knowledge of schizo-obsessive spectrum.

Obsessive-compulsive symptoms are associated with psychiatric comorbidities, behavioral and clinical problems: a population-based study of Brazilian school children.

Pediatric-onset obsessive-compulsive disorder (OCD) is underdiagnosed, and many affected children are untreated. The present study seeks to evaluate the presence and the clinical impact of OCD and obsessive-compulsive symptoms (OCS) in a large sample of school-age children. In Phase I, we performed an initial screening using the Family History Screen (FHS). In Phase II, we identified an "at-risk" sample, as well as a randomly selected group of children. A total of 2,512 children (6-12 years old) were assessed using the FHS, the Development and Well-Being Assessment (DAWBA), the Strengths and Difficulties Questionnaire (SDQ), and the Child Behavior Checklist (CBCL). Data analyses included descriptive and multivariate analytical techniques. 2,512 children (mean age: 8.86 ± 1.84 years; 55.0% male) were categorized into one of the three diagnostic groups: OCD (n = 77), OCS (n = 488), and unaffected controls (n = 1,947). There were no significant socio-demographic differences (age, gender, socioeconomic status) across groups. The OCS group resembled the OCD on overall impairment, including school problems and delinquent behaviors. However, the OCD group did have significantly higher rates of several comorbid psychiatric disorders, including separation anxiety, generalized anxiety, and major depressive disorder, than OCS or unaffected controls. Moreover, the OCD group also scored higher than the SDQ, as well as on each of CBCL items rated by the parent. Our findings suggest that there is a psychopathological continuum between OCS and OCD in school-aged children. The presence of OCS is associated with functional impairment, which needs further investigation in longitudinal studies.

Revisiting the Syndrome of "Obsessional Slowness".

Obsessional slowness (OS) denotes a rare condition of disablingly slow motor performance. It was originally described in patients with obsessive-compulsive disorder as a "primary" condition; however, subsequent reports have included heterogeneous clinical populations. We wished to reassess patients with this diagnosis at our own institution and also revisit the literature to provide an overview of this condition. Clinical documentation and videos of 3 patients diagnosed with OS in the National Hospital for Neurology and Neurosurgery (London, UK) were reviewed. One of the patients was clinically reappraised. A systematic review of published articles with sufficient clinical patient information was also conducted. Our 3 cases were male with symptom onset in adolescence or early adulthood. Motor slowness with poverty of movement and a history of obsessive-compulsive symptoms were characteristic. Poor speech production, bizarre postures, mannerisms, echophenomena, and oculogyric tics were also noted. Dopaminergic imaging was normal in 2 cases. One case had autistic features. Systematic literature review identified 77 further cases. Male preponderance with symptom onset mainly during the second decade and presence of obsessive-compulsive symptoms were noted. Additional motor and neuropsychiatric features were often present. The existence of OS as a "primary" condition is doubtful. This diagnosis has been given to characterize different clinical presentations ranging from obsessive-compulsive disorder with motor slowness resulting from covert obsessive-compulsive symptoms to catatonia. Clinicians should be aware of this syndrome to separate it from juvenile parkinsonism and other causes of motor slowness given that diagnostic approaches and treatment strategies differ.

The effect of obsessive-compulsive symptomatology on executive functions in schizophrenia: A systematic review and meta-analysis

The presence of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) is frequent in patients with schizophrenia and has been associated with greater functional impairment. The impact of these features on cognitive function is unclear. In this article, we performed a systematic review and meta-analysis to assess the effect of OCS/OCD on executive functions in schizophrenia patients. Results indicate that schizophrenia patients with OCS/OCD were more impaired in abstract thinking than schizophrenia patients without OCS/OCD. This finding provides support to the double jeopardy hypothesis and may partially explain the greater functional impairment shown in schizo-obsessive patients compared to those with schizophrenia. Inconsistent results were found for set-shifting, cognitive flexibility, cognitive inhibition and verbal fluency, as indicated by the high statistical heterogeneity found. Potential sources of heterogeneity such as definition of OCS/OCD, age of onset, severity of negative symptoms and premorbid intelligence were planned to be explored but there was an insufficient number of studies to perform these analyses. Our findings highlight the complexity of the relationship between OCS/OCD and schizophrenia and warrant further investigation of the cognitive function of schizo-obsessive patients.

The relationship between sub‐clinical obsessive‐compulsive symptoms and social cognition in chronic schizophrenia

Comorbid obsessive-compulsive (OC) symptoms in individuals with a primary diagnosis of schizophrenia are related to poorer cognitive performance and functional outcomes, but no study to date has assessed whether this comorbidity might also have implications for social cognition. The aim of the present study was to provide the first test of this possibility. Individuals with schizophrenia (n = 34) and demographically matched non-clinical controls (n = 44) were assessed on two of the most important aspects of social cognitive function (1) facial affect recognition and (2) theory of mind, alongside more standard measures of cognitive function. The presence of OC symptoms was related to poorer performance on some of the cognitive measures, as well as one of the social cognitive measures (facial affect recognition). However, these relationships disappeared after controlling for scores on more general indices of schizophrenia psychopathology. The presence of OC symptoms in schizophrenia is not only associated with increased cognitive impairment but also increased difficulties with at least some aspects of social cognitive function. However, these relationships appear to reflect the elevated levels of psychopathology seen in this cohort more generally, rather than being uniquely attributable to OC symptomatology.

Presence of obsessive compulsive symptoms in first‐episode schizophrenia or related disorders is associated with subjective well‐being and quality of life

The study aims to evaluate whether the presence of obsessive compulsive symptoms (OCS) in first-episode schizophrenia patients is associated with subjective well-being or quality of life. This study used a cross-sectional study of consecutively diagnosed patients with a first episode of schizophrenia or related disorder. There were 23 out of 198 (12%) consecutively assessed patients that reported co-morbid OCS. Co-morbid OCS were associated with a lower mean total score on a subjective well-being scale (P ≤ 0.001), especially on the social integration subscale (P = 0.002) and emotional regulation subscale (P = 0.008), and lower scores on subjective aspects of quality of life (P = 0.043), especially concerning mental health (P = 0.001) and physical health (P = 0.002). These results support the clinical relevance of OCS co-morbidity in schizophrenia or related disorders and the need for research into specific interventions.

Age-of-onset of schizophrenic and obsessive-compulsive symptoms in patients with schizo-obsessive disorder

Obsessive-compulsive symptoms (OCS) are prevalent, persistent, clinically significant phenomena in schizophrenia. To facilitate the understanding of their temporal interrelationship, we assessed age-of-onset of schizophrenic and obsessive-compulsive symptoms among 133 patients admitted to Tirat Carmel Mental Health Center (Israel) during the years 1999–2010 who met DSM-IV criteria for both schizophrenic disorder and obsessive-compulsive disorder (OCD). The mean age-of-onset of the first clinically significant OCS was significantly earlier than the mean age-of onset of the first psychotic symptoms. An earlier onset of OCS was detected in men, but not in women. In sixty-four of 133 patients OCS preceded the first psychotic symptoms, in 37 patients OCS followed them, and in 32 patients OCS and psychotic symptoms occurred simultaneously. A sub-analysis of 52 first-episode schizophrenia patients revealed that OCS emerged approximately 3years earlier than psychotic symptoms. Notably, schizo-obsessive patients had earlier mean age-of-onset of first psychotic symptoms than a comparative group of 113 non-OCD schizophrenia patients matched for age, gender and number of hospitalization. Earlier emergence of OCS than schizophrenic symptoms in schizo-obsessive patients suggests that they are independent of psychosis and are not consequent to schizophrenia. In addition, the presence of OCS seems to modify clinical features of schizophrenia accounting for earlier onset of first psychotic symptoms, however a replication of these findings is needed.

Obsessive-Compulsive Symptoms in Schizophrenia: Their Relationship With Clinical Features and Pharmacological Treatment

The aim of this study was to evaluate (1) the frequency of obsessive-compulsive symptoms (OCS) in patients with schizophrenia, (2) the impact of OCS on clinical features of schizophrenia, and (3) the association between type of antipsychotic treatment and presence of OCS. OCS were evaluated using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) in 70 patients with schizophrenia. The patients were then divided into two subgroups: those with at least a moderate level of OCS and those with mild or absent OCS. The two subgroups were compared using scores on the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), and the Global Assessment of Functioning Scale (GAF). Of the 70 patients with schizophrenia who were evaluated, 36 (51.4%) had at least moderate OCS (Y-BOCS score >16). SAPS subscale scores for hallucinations and delusions and GAF scores were found to be significantly higher among patients with at least moderate OCS, compared with those with mild or absent OCS. A significant relationship between at least moderate OCS and treatment with conventional antipsychotics was also observed. The presence of OCS seems to have the potential to affect clinical outcomes in schizophrenia and treatment with conventional antipsychotics appears to be correlated with the presence of OCS.

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.

Relationships Between Obsessive-Compulsive Symptomatology and Severity of Psychosis in Schizophrenia

The presence of obsessive-compulsive symptoms (OCS) or obsessive-compulsive disorder (OCD) is common in patients with schizophrenia. The impact of OCS and OCD on severity of psychotic symptoms has been assessed in several past studies yielding inconclusive results. In this report, we aim to integrate the findings of prior studies by means of a systematic review followed by a meta-analysis. A search of studies in PubMed (from 1950 to September 2006) and PsycINFO (from 1966 to September 2006) databases was performed to assess the influence of OCS and OCD on severity of psychotic symptoms in patients with schizophrenia using as syntax ("schizophrenia" OR "psychosis" OR "psychotic") AND ("obsessive-compulsive disorder" OR "OCD" OR "obsession*" OR "compulsion*" OR "obsessiv*" OR "compulsiv*"). Reference lists of all retrieved articles were also hand-searched. Twenty-three studies were included in the systematic review, and 18 articles provided usable data for the meta-analysis. All relevant data were extracted using a standardized report form by 2 investigators. Effect sizes and pooled estimates were calculated. Data were analyzed separately for studies using an OCS or OCD definition. The presence of OCS was significantly associated with greater severity of global psychotic symptoms (standardized mean difference [95% CI], 0.39 [0.14 to 0.64]), positive psychotic symptoms (0.28 [0.00 to 0.56]), and negative psychotic symptoms (0.36 [0.11 to 0.62]). In contrast, no differences in the severity of global psychotic symptoms (0.19 [-0.14 to 0.51]), positive psychotic symptoms (-0.01 [-0.20 to 0.19]), or negative psychotic symptoms (-0.11 [-0.30 to 0.08]) were found for the OCD versus non-OCD subgroups. This first meta-analysis revealed that the presence of obsessive-compulsive symptoms in schizophrenia is associated with higher global, positive, and negative psychotic symptoms. This association was not found when a categorical definition of obsessive-compulsive disorder was used.