Schizophrenia and OCD show symptomatic overlap

[David Baxter PhD]

Schizophrenia and OCD show symptomatic overlap
By Andrew Czyzewski
30 December 2008
Psychiatry Res 2009; 165: 38?46

Schizophrenia patients with comorbid obsessive compulsive disorder (OCD) display certain features in common with patients with OCD and poor insight, study findings show.

The researchers say their results suggest a degree of overlap between the disorders and speculate that there may be a ?schizophrenia-OCD spectrum.?

?The differences between OCD and schizophrenia seem to be related to thought disorders involving obsessions, overvalued ideas and delusions,? Filiz Karadag (Pamukkale University, Denizli, Turkey) and colleagues comment.

They explain that although obsessions have been defined as ideas that the affected person perceives as absurd and irrational, certain patients with OCD perceive their obsessions as rational and do not resist their symptoms.

Thus the concept of overvalued ideas in OCD may be related to poor insight as a psychotic dimension.

To thoroughly investigate the relationships between these disorders Karadag et al recruited 4 group of patients: those with OCD and schizophrenia (n=16), those with schizophrenia alone (n=30), those with OCD and good insight (n=30), and those with OCD and poor insight (n=13).

The researchers performed a full neuropsychological evaluation on the patients, including tests for executive functions and verbal and visual memory, and attention tasks.

Analysis revealed a general pattern of increasing executive dysfunction in order from patients with OCD and good insight, through to patients with OCD and poor insight, then schizophrenia with OCD, and finally patients with pure schizophrenia.

Thus these findings may support a degree of overlap between the two intermediate performing groups, say Karadag and co-workers.

They comment: ?Our results suggest that OCD patients with poor insight may represent a distinct subgroup neuropsychologically, possibly reflecting a transition between OCD and schizophrenia with regard to neuropsychological features.?

The research is published in the journal Psychiatry Research.

Abstract

 

[NicNak]

They comment: ?Our results suggest that OCD patients with poor insight may represent a distinct subgroup neuropsychologically, possibly reflecting a transition between OCD and schizophrenia with regard to neuropsychological features.?

When they say transition between OCD and Schizophrenia, does that mean that OCD of this type could progress to Schizophrenia?

This artical was very informative to me. I have seen some simular symptoms of Schizophrenia in myself. Although I am not sure if this applied to me if I would actually be aware of it? Maybe this artical explains it.

 

[David Baxter PhD]

No, I don't think so. I think what is being observed is an underlay of obsessive-compulsive traits that seems to be common in schizophrenia, or at least certain types of schizophrenia. It's probably closer to obsessive-compulsive personality disorder than OCD per se.

I've seen similar traits in bipolar disorder.

But there's no evidence I'm aware of to suggest that either OCPD or OCD "progresses" to schizophrenia.

 

[NicNak]

Thanks Dr Baxter for the clarification

 

[Daniel E.]

When they say transition between OCD and Schizophrenia, does that mean that OCD of this type could progress to Schizophrenia?

Most people with OCD -- from what I have read -- are in the good insight category.

Regarding schizophrenia, you might find this reassuring:

The average age of onset for schizophrenia is 16 to 25; late-onset, or paraphrenia, has been described as diagnosis after age 40.... paraphrenia [late onset] is not a progressive condition as schizophrenia often is.

Late-onset schizophrenia found to be distinct condition

 

[NicNak]

Thanks Daniel