The neuropsychology of the schizo-obsessive subtype of schizophrenia: a new analysis.
BACKGROUND
Interest in the neuro-cognitive profile of patients with schizophrenia and co-morbid obsessive compulsive disorder (schizo-OCD) is rising in response to reports of high co-morbidity rates. Whereas schizophrenia has been associated with global impairment in a wide range of neuro-cognitive domains, OCD is associated with specific deficits featuring impaired performance on tasks of motor and cognitive inhibition involving frontostriatal neuro-circuitry.


METHODS
We compared cognitive function using the CANTAB battery in patients with schizo-OCD (n=12) and a schizophrenia group without OCD symptoms (n=16). The groups were matched for IQ, gender, age, medication, and duration of illness.


RESULTS
The schizo-OCD patients made significantly more errors on a task of attentional set-shifting (ID-ED set-shift task). By contrast, no significant differences emerged on the Stockings of Cambridge task, the Cambridge Gamble Task or the Affective Go/NoGo tasks. No correlation emerged between ID-ED performance and severity of schizophrenia, OCD or depressive symptoms, consistent with neurocognitive impairment holding trait rather than state-marker status. Schizo-obsessives also exhibited a trend toward more motor tics emphasizing a neurological contribution to the disorder.ConclusionOur findings reveal a more severe attentional set-shifting deficit and neurological abnormality that may be fundamental to the neuro-cognitive profile of schizo-OCD. The clinical implications of these impairments merit further exploration in larger studies.
Patel
D D
DD
School of Psychology, University of Hertfordshire, Hatfield AL10 9AB, UK.
Laws
K R
KR
Padhi
A
A
Farrow
J M
JM
Mukhopadhaya
K
K
Krishnaiah
R
R
Fineberg
N A
NA
D000328:Adult; D000339:Affect / Q000502:physiology; D000368:Aged; D001288:Attention / Q000502:physiology; D015897:Comorbidity; D003342:Corpus Striatum / Q000503:physiopathology; D003937:Diagnosis, Differential; D017831:Diagnosis, Dual (Psychiatry); D004192:Discrimination, Psychological / Q000502:physiology; D056344:Executive Function / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000503:physiopathology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011597:Psychomotor Performance / Q000502:physiology; D011930:Reaction Time / Q000502:physiology; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology; D012565:Schizophrenic Psychology; D012660:Semantics; D055815:Young Adult