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David Baxter PhD

Late Founder
Obsessive-Compulsive symptoms central clinical features of schizophrenia
By Lucy Piper
15 July 2010
Compr Psychiatry 2010; 51: 357?362

Obsessive-compulsive (OC) symptoms in patients with schizophrenia appear to be central to the clinical features of the condition and not a separate clinical condition, study findings suggest.

The results also show that the presence of OC symptoms is associated with more severe psychotic symptoms and impaired quality of life.

Ahmet Tiryaki and Evrim ?zkorumak from Karadeniz Technical University in Turkey examined symptom domains, cognitive functions, and quality of life in 62 patients with schizophrenia.

The prevalence of OC symptoms among the patients was high, at 35.5% (n=22). The mean duration of OC symptoms was 120 months, with symptoms occurring before schizophrenia in the majority (86.4%) of patients.

In contrast with previous findings, there was no significant difference between the group of patients with and without OC symptoms, although the researchers report a negative correlation between the age of onset of schizophrenia and total and compulsion subscores on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).

The overall Y-BOCS score for the patients with OC symptoms was 14.82, and the mean obsessions and compulsion subscores were 6.86 and 8.68, respectively.

Psychotic symptom scores for the groups of patients with and without OC symptoms were comparable, but total scores on the Scale for the Assessment of Positive Symptoms (SAPS) were higher in patients with OC symptoms than in those without such symptoms, at 17.73 versus 10.05.

Obsession and delusion subscores also positively correlated with each other, and there was a positive correlation between Y-BOCS compulsion subscore and both total SAPS score and SAPS bizarre behaviors subscore.

OC symptoms had no effect on neurocognitive functions, however.

The quality of life of the patients differed, with lower, albeit not significantly, total scores on the Quality of Life Scale (QLS) for patients with than without OC symptoms, at 59.14 and 70.00, respectively.

Scores for the subscales occupational role, and personal equipment and daily activities were also lower among patients with OC symptoms.

The researchers note that, while there was no correlation between quality of life and Y-BOCS scores, there was a correlation between mean total QLS score and Scale for the Assessment of Negative Symptoms -total and SAPS-total scores.

Tiryaki and ?zkorumak comment in the journal Comprehensive Psychiatry that "schizophrenia with OC symptoms has a clinical picture including severe psychotic symptoms with worse quality of life."

They conclude: "OC symptoms are close to central clinical features of the disease rather than being an additional clinical condition, and they might be considered within the symptom domains of schizophrenia."

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