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Comorbid Obsessive-Compulsive Symptoms in Schizophrenia - Diagnostic and Treatment Challenges

Published online by Cambridge University Press:  19 July 2023

J. A. Leal ,
J. C. Moura ,
T. C. Rocha ,
J. F. Cunha ,
S. P. Torres ,
D. Seabra ,
I. M. Lopes ,
M. E. Carneiro ,
S. M. Esteves  and
R. Cajão
...Show all authors
J. A. Leal*
Affiliation:
Psychiatry, Centro Hospitalar Barreiro Montijo, E.P.E., Setúbal, Portugal
J. C. Moura
Affiliation:
Psychiatry, Centro Hospitalar Barreiro Montijo, E.P.E., Setúbal, Portugal
T. C. Rocha
Affiliation:
Psychiatry, Centro Hospitalar Barreiro Montijo, E.P.E., Setúbal, Portugal
J. F. Cunha
Affiliation:
Psychiatry, Centro Hospitalar Barreiro Montijo, E.P.E., Setúbal, Portugal
S. P. Torres
Affiliation:
Psychiatry, Centro Hospitalar Barreiro Montijo, E.P.E., Setúbal, Portugal
D. Seabra
Affiliation:
Psychiatry, Centro Hospitalar Barreiro Montijo, E.P.E., Setúbal, Portugal
I. M. Lopes
Affiliation:
Psychiatry, Centro Hospitalar Barreiro Montijo, E.P.E., Setúbal, Portugal
M. E. Carneiro
Affiliation:
Psychiatry, Centro Hospitalar Barreiro Montijo, E.P.E., Setúbal, Portugal
S. M. Esteves
Affiliation:
Psychiatry, Centro Hospitalar Barreiro Montijo, E.P.E., Setúbal, Portugal
R. Cajão
Affiliation:
Psychiatry, Centro Hospitalar Barreiro Montijo, E.P.E., Setúbal, Portugal
G. Lima
Affiliation:
Psychiatry, Centro Hospitalar Barreiro Montijo, E.P.E., Setúbal, Portugal
*
*Corresponding author.

Abstract

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Introduction

The comorbidity between Schizophrenia and Obsessive-Compulsive Symptoms represents almost 25% of schizophrenic patients and it is believed that almost 12% match the diagnostic criteria for Obsessive-Compulsive Disorder. Some second-generation antipsychotics may worsen or even induce those symptoms, which makes the treatment of this patients a difficult challenge.

Objectives

To assess the link between Schizophrenia and Obsessive-Compulsive Symptoms, to discuss the diagnostic challenges and treatment options. To present a clinical case report of a schizophrenic patient with Obsessive-Compulsive Symptoms, which improved with proper treatment.

Methods

We performed a non-systematic review of the existent literature with the keywords “Schizophrenia” and “Obsessive-Compulsive Symptoms”. Description of a clinical case report.

Results

We present the case report of a male, 21 years old, single, diagnosed with Schizophrenia. In the past year, he was admitted twice in a psychiatric ward for persecutory and mystic delusions, which lead him to erratic behaviour. Since his adolescence he manifested repeated washing and compulsive cleaning associated with the fear of being contaminated with multiple diseases. Those compulsions worsened when he started being treated with antipsychotics. However, with therapeutic adjustments and with the introduction of an antidepressant we were able to control those symptoms.

Conclusions

Some antipsychotics may induce or even aggravate Obsessive-Compulsive Symptoms in psychotic patients. It is of extreme relevance to differentiate those symptoms as comorbid in Schizophrenia or if they existed prior to the first positive symptoms, since they can be representative of an Obsessive-Compulsive Disorder. Understanding this diagnostic and treatment complexity enables us to be more familiar with the development of Obsessive-Compulsive Symptoms in schizophrenic patients.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S1061
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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