title: Prevalence and clinical correlates of obsessive-compulsive disorder in schizophrenia.
abstract: Obsessive compulsive symptoms frequently occur in a substantial proportion of patients with schizophrenia. The term schizoobsessive has been proposed to delineate this subgroup of schizophrenia patients who present with obsessive-compulsive symptoms/disorder. However, whether this co-occurrence is more than just co-morbidity and represents a distinct subgroup remains controversial. A striking variation is noted across studies examining prevalence of obsessive-compulsive symptoms/disorder in schizophrenia patients and their impact on clinical profile of schizophrenia. Hence, in this study, we examined the prevalence of obsessive-compulsive symptoms/disorder in a large sample of consecutively hospitalized schizophrenia patients and compared the clinical and functional characteristics of schizophrenia patients with and without obsessive-compulsive symptoms/disorder. We evaluated 200 consecutive subjects with the DSM-IV diagnosis of schizophrenia using the Structured Clinical Interview for DSM-IV Axis I disorders, Positive and Negative Syndrome Scale, Yale-Brown Obsessive-Compulsive Scale, Brown Assessment of Beliefs Scale, Clinical Global Impression-Severity scale, Global Assessment of Functioning Scale, Family Interview for Genetic Studies and World Health Organization Quality of Life scale. The prevalence of obsessive-compulsive symptoms in patients with schizophrenia was 24% (n=48); 37 of them had obsessive-compulsive disorder (OCD) and 11 had obsessive-compulsive symptoms not amounting to a clinical diagnosis of OCD (OCS). Schizophrenia patients with OCS/OCD had an earlier age at onset of schizophrenia symptoms, lower positive symptoms score, higher co-morbidity with Axis II disorders, higher occurrence of OCD in family and better quality of life. Findings of the study indicate a higher prevalence of OCS/OCD in schizophrenia. Schizophrenia patients with and without OCS/OCD have comparable clinical profile with few exceptions. High rates of OCD in first degree relatives suggest possible genetic contributions and differences in neurobiology. Finally, evidence to consider schizoobsessive as a distinct diagnostic entity is inconclusive and warrants further studies.
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Sugnyani
authors.initials: S
authors.lastname: Devi
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India; Centre for Neuroscience, Indian Institute of Science, Bangalore, India.
authors.forename: Naren P
authors.initials: NP
authors.lastname: Rao
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Suresh
authors.initials: S
authors.lastname: Badamath
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: C R
authors.initials: CR
authors.lastname: Chandrashekhar
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India. Electronic address: ycjreddy@gmail.com.
authors.forename: Y C
authors.initials: YC
authors.lastname: Janardhan Reddy
mesh_terms: D000328:Adult; D017668:Age of Onset; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005190:Family; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D011788:Quality of Life; D012559:Schizophrenia / Q000150:complications* / Q000453:epidemiology; D012565:Schizophrenic Psychology