title: Differential effects of antipsychotic agents on obsessive-compulsive symptoms in schizophrenia: a longitudinal study.
abstract: Indirect evidence supports the assumption that antiserotonergic second-generation antipsychotics (SGA) induce and aggravate obsessive-compulsive symptoms (OCS) in schizophrenia. However, multimodal studies assessing the long-term interaction of pharmacotherapy and psychopathology are missing. Over 12 months, we followed-up 75 schizophrenia patients who were classified into two groups according to antipsychotic treatment: clozapine or olanzapine (group I) versus aripiprazole or amisulpride (group II). We applied the Yale Brown Obsessive Compulsive Scale (YBOCS) and investigated between-group changes over time as the primary endpoint. Group I showed markedly higher YBOCS scores at both time points. Repeated measure analyses of variance (ANOVAs) revealed significant interaction effects of group and time (per protocol sample (PP): p=0.006). This was due to persistently high OCS severity within group I, and decreasing YBOCS scores within group II. OCS severity correlated significantly with the negative and general psychopathology subscales of the Positive and Negative Syndrome Scale (PANSS), as well as with depressive symptoms. The progressive differences in OCS severity between our groups support the assumption of differential pharmacodynamic effects on comorbid OCS in schizophrenia. Further studies should address the pathogenetic mechanism, define patients at risk and facilitate early detection as well as therapeutic interventions.
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany. frederike.schirmbeck@zi-mannheim.de
authors.forename: Frederike
authors.initials: F
authors.lastname: Schirmbeck
authors.forename: Franziska
authors.initials: F
authors.lastname: Rausch
authors.forename: Susanne
authors.initials: S
authors.lastname: Englisch
authors.forename: Sarah
authors.initials: S
authors.lastname: Eifler
authors.forename: Christine
authors.initials: C
authors.lastname: Esslinger
authors.forename: Andreas
authors.initials: A
authors.lastname: Meyer-Lindenberg
authors.forename: Mathias
authors.initials: M
authors.lastname: Zink
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015897:Comorbidity; D003863:Depression / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018492:Dopamine Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009770:Obsessive Behavior / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control; D010352:Patient Dropouts; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D012702:Serotonin Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D014150:Antipsychotic Agents; D018492:Dopamine Antagonists; D012702:Serotonin Antagonists; D017367:Selective Serotonin Reuptake Inhibitors