Preferential aggregation of obsessive-compulsive spectrum disorders in schizophrenia patients with obsessive-compulsive disorder.
ABSTRACT To validate a complex association between schizophrenia and obsessive-compulsive disorder (OCD).
We used the Structured Clinical Interview for DSM-IV Axis I disorders to compare the rate of OCD spectrum and additional Axis I disorders in 100 patients who met criteria for both schizophrenia and OCD, non-OCD schizophrenia (n = 100), and OCD (n = 35).
There was a robust between-group difference in the number of patients with one or more OCD spectrum disorders (schizo-obsessive n = 30, compared with schizophrenia n = 8; P = 0.001), that is, higher rates of body dysmorphic (8% compared with 0%) and tic (16% compared with 4%) disorders. No difference was revealed in affective, anxiety, and substance use disorders. We found comparable rates of OCD spectrum disorders in the schizo-obsessive and OCD groups (30% and 42.8%, respectively; P = 0.32).
Preferential aggregation of OCD spectrum disorders in the schizo-obsessive group supports this unique clinical association. Whether a schizo-obsessive interface represents comorbidity or a specific subtype of schizophrenia warrants further investigation.
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ABSTRACT: Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder affecting approximately 1-3% of the population. OCD is probably an etiologically heterogeneous condition. Individuals with OCD frequently have additional psychiatric disorders concomitantly or at some time during their lifetime. Recently, some authors proposed an OCD sub-classification based on comorbidity. An important issue in assessing comorbidity is the fact that the non-response to treatment often involves the presence of comorbid conditions. Non-responsive patients are more likely to meet criteria for comorbid axis I or axis II disorders and the presence of a specific comorbid condition could be a distinguishing feature in OCD, with influence on the treatment adequacy and outcome.Frontiers in Psychiatry 12/2011; 2:70. DOI:10.3389/fpsyt.2011.00070
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ABSTRACT: Obsessive-compulsive phenomena in schizophrenia: a review The relationship between schizophrenia and obsessive-compulsive disorder/obsessive-compulsive symptom (OCD/OCS) has increasingly become the focus of clinical attention in the last years. Despite the growing body of evidence supporting the existence of an epidemiologic and neurobiologic relation between OCD and schizophrenia, the association remains poorly understood. This paper reviews published articles from five perspectives: Hierarchical model and terminology, schizophrenia with obsessive-compulsive symptoms, obsessive-compulsive disorder (OCD) with psychotic symptoms, obsessive-compulsive symptoms induced by atypical antipsychotics and neurobiology of schizophrenia and OCD. A MEDLINE search was conducted to identify relevant articles from 1980 until 2007. The epidemiologic data strongly suggest a unique relation between these two disorders, given the marked degree of comorbidity. The neurobiologic data on each disorder suggest the involvement of common brain regions and neurotransmitter systems, although there is very limited neurobiologic research focusing specifically on the putative schizophrenia-and-OCD subtype. The question of whether the two disorders are part of a more complex syndrome (possibly representing a distinct diagnostic entity) remains unanswered and is the core focus of the present paper.