Obsessive compulsive symptoms in schizophrenia: frequency and clinical features.
OBJECTIVE
Prior studies have evaluated the occurrence and clinical effects of obsessive-compulsive (OC) symptoms in schizophrenia with varied results. This study systematically assessed the frequency and clinical impact of OC symptoms among outpatients with schizophrenia and schizoaffective disorder.


METHODS
One hundred subjects with schizophrenia or schizoaffective disorder were evaluated with a 20-question detailed screen for the presence of OC symptoms. The severity of OC symptoms was assessed with the Yale Brown Obsessive-Compulsive Scale (Y-BOCS). Fifty-eight patients participated in subsequent assessments comparing schizophrenia severity (Positive and Negative Syndrome Scale) functional status (Social and Occupational Functioning Scale) and resource utilization (psychiatric hospitalization) of OC (N=21) and non-OC (N=37) patients.


RESULTS
Thirty percent of patients exhibited two or more OC symptoms, and 19% had at least moderate OC symptoms (Y-BOCS score >or= 16). Twenty-three percent met full DSM-IV criteria for OCD. There were no differences observed between the OC and non-OC groups on any of the clinical outcomes. OC symptoms were developed prior to the onset of schizophrenia in only 28% of patients.


CONCLUSIONS
Nearly one-third of patients exhibited clinically significant OC symptoms in this systematic, cross-sectional assessment. However, OC symptoms did not appear to impact the clinical outcome of patients. In most cases, OC symptoms began concurrently with or after the onset of the psychotic disorder. Studies are needed to define the relevance and pathological basis for the co-occurrence of OC symptoms in persons with schizophrenia.
Byerly
Matthew
M
UT Southwestern, Psychiatry, 6363 Forest Park Road, Suite 651, Dallas 75235, TX, USA. Matt.Byerly@utwestern.edu
Goodman
Wayne
W
Acholonu
Wilfred
W
Bugno
Rhiannon
R
Rush
A John
AJ
D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012559:Schizophrenia / Q000453:epidemiology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires