Comorbidity and pathophysiology of obsessive-compulsive disorder in schizophrenia: is there evidence for a schizo-obsessive subtype of schizophrenia?
Epidemiologic and neurobiologic evidence suggests that patients with comorbid obsessive-compulsive disorder (OCD) and schizophrenia may represent a special category among patients with schizophrenia. Efforts to examine the neurobiology of this group have focused on neuroimaging studies and neuropsychologic testing. Convergent evidence suggests that there may be a specific pattern of neurobiologic dysfunction in this subgroup of patients accounting for symptom co-expression. This review indicates that future studies should distinguish among (1) apparent obsessive-compulsive symptoms (OCS) that occur only in the context of psychosis and that may overlap with psychotic phenomenology, representing a forme fruste of psychosis; (2) OCS occurring only in the prodromal phase of schizophrenia; (3) neuroleptic-induced OCS or OCD; and (4) OCS or frank OCD occurring concurrently with schizophrenia. We examine the evidence for a putative schizo-obsessive disorder and outline suggestions for identifying OCS in the presence of psychosis.
Bottas
Alexandra
A
Department of Psychiatry, University of Toronto, ON, Canada. bottasa@wmhc.ca
Cooke
Robert G
RG
Richter
Margaret A
MA
D003952:Diagnostic Imaging; D006801:Humans; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000145:classification / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D012559:Schizophrenia / Q000145:classification / Q000150:complications / Q000503:physiopathology*; D012565:Schizophrenic Psychology