Schizophrenia with obsessive compulsive symptoms ‘a distinct subtype’
MedWire News: Results from a Japanese study suggest that schizophrenia with obsessive-compulsive symptoms (OCS) may represent a subtype of the disorder that is associated with early onset and increased severity of psychotic symptoms.
"Schizophrenic patients exhibiting OCS are often clinically encountered in psychiatric departments," write Toshimi Owashi (Showa University Fujigaoka Hospital, Yokohama) and team.
However, they add that to date "no clear understanding of the effects of obsessive-compulsive disorder (OCD) or OCS on schizophrenia has been established."
To address this, the researchers studied 92 inpatients (45 males) with chronic schizophrenia who were aged an average of 58.1 years. The mean age at onset of schizophrenia was 22.3 years and the mean age at first admission for the disorder was 26.2 years.
All of patients were assessed for psychiatric symptoms and OCS using the Brief Psychiatric Rating Scale (BPRS) and the Yale-Brown Obsessive Compulsive Scale (YBOCS), respectively. The Mini-International Neuropsychiatric Interview (MINI) was used to diagnose OCD.
Overall, 51.1% (n=47) of patients had OCS and 14.1% (n=13) were diagnosed with OCD.
Analysis revealed that schizophrenia patients with OCD or OCS had a significantly earlier age at onset of schizophrenia than schizophrenia patients without OCS, at 20.5 and 20.2 years versus 24.4 years, respectively, as well as a significantly earlier age at first hospitalization for schizophrenia, at 24.3 and 23.6 years versus 28.7 years, respectively.
Furthermore, patients with OCD or OCS had significantly higher positive symptom scores on the BPRS than those without OCS, at 13.7 and 14.7 versus 11.6, respectively.
The researchers also note that patients with OCD and those with OCS were being treated with significantly higher doses of antipsychotics than those without OCS.
Owashi and team conclude in the journal Psychiatry Research: "Our findings suggest there is a subtype of schizophrenia with OCS, which is related to earlier onset and more severe psychotic symptoms."
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By Mark Cowen