Comparison of Clinical Characteristics and Comorbidity in Schizophrenia Patients With and Without Obsessive-Compulsive Disorder: Schizophrenic and OC Symptoms in Schizophrenia. [CME]
J Clin Psychiatry 2003;64(11):1300-1307
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Since a substantial proportion of
schizophrenia patients has symptoms of obsessive-compulsive
disorder (OCD), we sought to provide a phenomenological
characterization of a schizophrenia subgroup with OCD.
Method: A consecutive sample of patients who met
DSM-IV criteria for both schizophrenia and OCD (N = 55) was
compared with 55 schizophrenia patients without OCD matched for
age and number of hospitalizations. Structured Clinical Interview
for DSM-IV Axis I psychiatric disorders (SCID-I), including a
specific module for tic disorders based on DSM-IV criteria,
Scales for the Assessment of Positive and Negative Symptoms,
Yale-Brown Obsessive-Compulsive Scale, Clinical Global
Impressions scale, and Hamilton Rating Scale for Depression were
Results: Schizophrenia patients with OCD (N =
55) had lower positive dimension scores than schizophrenia
patients without OCD (N = 55) (p = .01). Two subgroups of
schizo-obsessive patients were identified: OCD independent of
schizophrenia symptoms and OCD partially overlapping positive
schizophrenia symptoms. Schizophrenia patients with OCD had more
SCID-detectable OCD-spectrum disorder, primarily body dysmorphic
disorder and chronic tic disorders. More schizophrenia patients
with OCD were treated with either add-on serotonin reuptake
inhibitors or clozapine.
Conclusion: Schizophrenia patients with OCD
differ from their non-OCD-schizophrenia counterparts in severity
of schizophrenia symptoms, co-occurrence of OCD-spectrum
disorders, and pharmacotherapy. These findings and the
identification of 2 subgroups of schizo-obsessive patients
support the validity of this unique clinical entity and may
facilitate the establishment of diagnostic criteria for a
schizo-obsessive subtype of schizophrenia.