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A Profile of Obsessive-Compulsive Symptoms In Schizophrenia

Published online by Cambridge University Press:  07 November 2014

Linda Porto ,
Paul C. Bermanzohn ,
Simcha Pollack ,
Richard Morrissey  and
Samuel G. Siris
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Abstract

Obsessive-compulsive (OC) symptoms and schizophrenia may present, as intertwined phenomena whose relationship remains poorly understood. The purpose of this paper is to provide a detailed phenomenological description of OC symptoms in schizophrenia.

Fifty long-term patients with chronic schizophrenia or schizoaffective disorder from a continuing day-treatment program were assessed using the Structured Clinical Interview for DSM-IV and the Yale-Brown Obsessive-Compulsive Scale symptom checklist. Forty-six percent (n=23) reported clinically significant OC symptoms. Twenty-six percent (n=13) met criteria for OCD, from which three subgroups emerged: (1) patients whose OCD was unrelated to their psychotic symptoms, (2) patients whose OCD was related to, but not restricted to, their psychotic symptoms, and (3) patients whose OC symptoms existed on a continuum with their psychosis. The last group tended to incorporate their OC symptoms into delusional beliefs during the active phase of illness and shift to OCD during full or partial remissions. Eight percent met all inclusion criteria for OCD, but their OC symptoms were better accounted for by their psychosis.

We conclude that these findings support previous clinical constructs that OCD and schizophrenia are not always dichotomous disorders, but may be interconnected.

Type
Feature Articles
Information
CNS Spectrums , Volume 2 , Issue 3: Schizophrenia & OCD: Convergence , March 1997 , pp. 21 - 25
Copyright
Copyright © Cambridge University Press 1997

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References

1.Jahrrheis, W. Obsessions during schizophrenia (German). Arch Psych Nervenkr. 1926;77:740–788.Google Scholar
2.Rosen, I. The clinical significance of obsessions in schizophrenia. J Ment Sci. 1957;103:773–788.Google Scholar
3.Fenton, WS, McGlashen, TH. The prognostic significance of obsessive-compulsive symptoms in schizophrenia. Am J Psychiatry. 1986:143:437–441.Google Scholar
4.Berman, I, Kalinowski, A, Berman, SM, Lengua, J, Green, AI. Obsessive and compulsive symptoms in chronic schizophrenia. Compr Psychiatry. 1995;36(l):6–10.CrossRefGoogle ScholarPubMed
5.Bland, RC, Newman, SC, Orn, H. Schizophrenia: lifetime comorbidity in a community sample. Acts Psychiatr Scand. 1987;75:383–391.Google Scholar
6.Stoll, AL, Tohen, M, Baldessarini, R. Increasing frequency of the diagnosis of obsessive compulsive disorder. Am J Psychiatry. 1992;149(5):638–640.Google Scholar
7.Eisen, JL, Beer, DA, Pato, MT, Venditto, TA, Rasmussen, SA. Obsessive-compulsive disorder in patients with schizophrenia or schizoaffective disorder. Am J Psychiatry. 1997;154(2):271–273.Google ScholarPubMed
8.Insel, TR, Akiskal, HS. OCD with psychotic features: a phenomenologic analysis. Am J Psychiatry. 1986:143(12):-1527–1533.Google Scholar
9.Bermanzohn, PC, Porto, L, Arlow, PB, et al.Are some neuroleptic-refractory symptoms of schizophrenia really obsessions? CNS Spectrums. 1997;2(3):51–57.CrossRefGoogle Scholar
10.Birnie, WA, Littmann, SK. Obsessionality and schizophrenia. Can Psychiatr Assoc J. 1978:23:72–78.Google Scholar
11.Weiss, AA, Robinson, S, Winnik, HZ. “Obsessive psychosis”:psychodiagnostic findings. Isr Ann Psychiatr Reiat Discip. 1969;7(2):175–178.Google Scholar
12.Robinson, S, Winnik, HZ, Weiss, AA. “Obsessive psychosis”:justification for a separate clinical entity. Isr Ann Psychiatr Relat Discip. 1976;14(l):39–48.Google Scholar
13.Chopra, HD. Psychosis in obsessive-compulsive disorder. Am J Psychiatry. 1987;144(10):1363–1364. Letter.Google ScholarPubMed
14.Lewis, SW, Chitkara, B, Reveley, AM. Obsessive-compulsive disorder and schizophrenia in three identical twin pairs. Psychol Mecf. 1991;21(1):135–141.Google Scholar
15.Stein, D, Hollander, E. The Spectrum of Obsessive-Compulsive-Related Disorders. In: Hollander, E, ed. Obsessive Compulsive-Related Disorders. Washington, DC: American Psychiatric Press; 1993:244–245Google Scholar
16.Lewis, A. Problems of obsessional illness. Proc R Soc Med. 1936:29:325–336.Google Scholar
17.Kindler, S, Kaplan, Z, Zohar, Y, et al.Obsessive-compulsive symptoms in schizophrenia. In: Hollander, E, ed. Obsessive compulsive-related disorders. Washington, DC: American Psychiatric Press; 1993; 203–214.Google Scholar
18.Bermanzohn, PC, Porto, L, Siris, SG. Hierarchical diagnosis in schizophrenia. Proceedings of the 35th Annual Meeting of the American College of Neuropsychopharmacology; December 9–13,1996; San Juan, Puerto Rico.Google Scholar
19.First, MB, Spitzer, RL, Gibbon, M, Williams, JBW. Structured Clinical Interview tor Axis I DSM-IV Disorders: Patient Edition (SCID-I/P, Version 2.0). Biometrics Research Department, New York State Psychiatric Institute, 1994.Google Scholar
20.Goodman, WK, Price, LH, Rasmussen, SA, et al.The Yale-Brown Obsessive Compulsive Scale: I. development, use, and reliability. Arch Gen Psychiatry. 1989:46:1006–1011.Google Scholar
21.American Psychiatric Association (APA): Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Washington, DC: American Psychiatric Press; 1994.Google Scholar
22.Hunter, R, Mac Alpine, I. Three Hundred Years Of Psychiatry. London. Oxford University Press.Google ScholarGoogle Scholar
23.American Psychiatric Association (APA): Diagnostic and Statistical Manual of Mental Disorders (Third Edition-Revised). Washington, DC: American Psychiatric Press;1987.Google Scholar
24.Hwang, MY, Opler, LA, eds. Schizophrenia with Obsessive-Compulsive Features: Assessment and Treatment. Psych Annals. 1991;24(9):468–472.CrossRefGoogle Scholar
25.Strauss, JS. Diagnostic models and the nature of psychiatric disorder. Arch Gen Psychiatry. 1973:29:445–449.Google Scholar
26.Kendell, RE. The Role of Diagnosis in Psychiatry. Blackwell Scientific Publications. Oxford. Distributed in the US by JB Lippincott Co., Philadelphia; 1975.Google Scholar
27.Doran, AR, Breier, A, Roy, A. Differential diagnosis and diagnostic systems in schizophrenia. Psychiatry Clin North Am. 1986;9(1):17–33.Google Scholar
28.Tynes, LL, White, K, Steketee, GS. Toward a new nosology of obsessive compulsive disorder. Compr Psychiatry. 1990;31(5):465–480.Google Scholar
29.Chen, E, Berrios, GE. Recognition of hallucinations: a new multidimensional model and methodology. Psychopathology. 1996;29(1):54–63.Google Scholar
30.Hollander, E, Benzequen, S. Is there a distinct OCD spectrum? CNS Spectrums. 1996:1(1)17–26.Google Scholar
31.Opler, L, Hwang, M. Schizophrenia: a multidimensional disorder. Psychiatric Annals. 1994:24:9.Google Scholar