title: The 5-year course of obsessive-compulsive symptoms and obsessive-compulsive disorder in first-episode schizophrenia and related disorders.
abstract: OBJECTIVE
  To determine the course of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) in first-episode schizophrenia and related disorders and their relationship with clinical characteristics.
  
  
  METHODS
  Consecutively, admitted patients with a first-episode of schizophrenia, schizophreniform disorder, or schizoaffective disorder were screened for OCS, and these were measured with the Yale-Brown Obsessive-Compulsive Scale. Positive and Negative Syndrome Scale and Montgomery Åsberg Depression Rating Scale were used to assess severity of other symptoms. The course of 3- and 5-year symptoms, psychotic relapse, substance use, remission, full recovery, suicide, and social functioning were assessed.
  
  
  RESULTS
  One hundred and eighty-six consecutively admitted and consenting patients were included. Five years after admission, OCS could be assessed in 172 patients. Ninety-one patients (48.9%) reported no OCS symptoms on any of the assessments. OCS restricted to the first assessments occured in 15.1%, 13.4% had persistent OCS, 7.0% had no OCS at first assessment but developed OCS subsequently, and 15.6% had intermittent OCS. The proportion of patients with comorbid OCD varied between 7.3% and 11.8% during follow-up. OCD was associated with more severe depressive symptoms and poorer premorbid functioning and social functioning at follow-up.
  
  
  CONCLUSIONS
  The 5-year course of OCS/OCD in patients with first-episode schizophrenia or related disorders is variable. OCS/OCD comorbidity was not associated with a more severe course of psychotic symptoms and relapse. Comorbid OCD was associated with more severe depressive symptoms, social dysfunction and worse premorbid functioning. Specific treatment options for schizophrenia patients with comorbid OCD are needed.
authors.affiliation: Department of Psychiatry, Early Psychosis Section, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 105 AZ Amsterdam, The Netherlands. l.dehaan@amc.uva.nl
authors.forename: Lieuwe
authors.initials: L
authors.lastname: de Haan
authors.forename: Bouke
authors.initials: B
authors.lastname: Sterk
authors.forename: Luuk
authors.initials: L
authors.lastname: Wouters
authors.forename: Don H
authors.initials: DH
authors.lastname: Linszen
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology / Q000503:physiopathology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D012559:Schizophrenia / Q000453:epidemiology / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D013997:Time Factors; D055815:Young Adult