The schizo-obsessive disorder: a case report

Authors

  • Anna Urbańska II Department of Psychiatry and Psychiatric Rehabilitation of the Medical University in Lublin Author
  • Agnieszka Lis II Department of Psychiatry and Psychiatric Rehabilitation of the Medical University in Lublin Author
  • Mateusz Sołowiej Neuropsychiatric Hospital in Lublin Author
  • Aneta Perzyńska-Starkiewicz II Department of Psychiatry and Psychiatric Rehabilitation of the Medical University in Lublin Author
  • Diana Szymczuk II Department of Psychiatry and Psychiatric Rehabilitation of the Medical University in Lublin Author
  • Marcin Olajossy II Department of Psychiatry and Psychiatric Rehabilitation of the Medical University in Lublin Author

DOI:

https://doi.org/10.1515/cpp-2016-0031

Keywords:

schizophrenia, obsessive-compulsive disorder, schizo-obsessions, schizo-obsessive disorder, case history

Abstract

Purpose: A case of schizophrenia with coexisting obsessive-compulsive symptoms is reported.

Case: The frequency of obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) occurrence among patients suffering from schizophrenia is considerably higher in comparison to general population. The results of some studies show that schizo-obsessive disorder is characterized by higher intensity of negative and depressive symptoms. Patients with comorbid schizophrenia and obsessive-compulsive disorder show greater level of social dysfunction and they exhibit suicidal behaviours more often than patients diagnosed with schizophrenia. We present a 33-year-old female with obsessive-compulsive symptoms with onset in her early teens with no satisfactory response to treatment, in spite of her good intellect and insight into illness and cooperation.

Comment: There is some evidence suggesting that patients with “schizo-obsessive disorder” have a worse prognosis com-pared to the group of patients suffering only from schizophrenia, but the effect of OCD on schizophrenia symptom profile is unclear.

References

1. Patel D. D., Laws K. R., Padhi A., Farrow J. M., Mukhopadhaya K., Krishnaiah R., Fineberg N. A. The neuropsychology of the schizo-obsessive subtype of schizophrenia: a new analysis. Psychological Medicine 2010; 40: 921-933.

2. Crino R., Slade T., Andrews G. The changing prevalence and severity of obsessive-compulsive disorder criteria from DSM-III to DSM-IV. American Journal of Psychiatry 2005; 162: 876-882

3. Frías A., Palma C., Farriols N., Becerra C., Álvarez A., Cañete J. Neuropsychological profile and treatment-related features among patients with comorbidity between schizophrenia spectrum disorder and obsessive–compulsive disorder: Is there evidence for a “schizo-obsessive” subtype? Psychiatry Research 2014; 220: 846–854

4. Poyurovsky M., Weizman A., Weizman R. Obsessive-compulsive disorder in schizophrenia: clinical characteristics and treatment. CNS Drugs 2004; 18: 989-1010.

5. Frías Á., Palma C., Farriols N., Salvador A., Bonet J., Bernáldez I. Psychopathology and quality of life among patients with comorbidity between schizophrenia spectrum disorder and obsessive-compulsive disorder: no evidence for a “schizo-obsessive” subtype. Comprehensive Psychiatry 2014; 55: 1165-1173.

6. Frías A., Palma C., Farriols N., Commorbidity between obsessive-compulsive disorder and schizophrenia: Prevalence, explanatory theories, and nosological status. Actas Españolas de Psiquiatría 2014; 42 (1): 28-38

7. Bottas A., Cooke R., Richter M. Comorbidity and pathophysiology of obsessive-compulsive disorder in schizophrenia: Is there evidence for a schizo-obsessive subtype of schizophrenia? Journal of Psychiatry and Neuroscience 2005; 30 (3): 187-193

8. Nechmad A., Ratzoni G., Poyurovsky M., Meged S., Avidan G., Fuchs C., et al. Obsessive-compulsive disorder in adolescent schizophrenia patients. American Journal of Psychiatry 2003; 160: 1002-4.

9. Ongur D., Goff D.C. Obsessive-compulsive symptoms in schizophrenia: associated clinical features, cognitive function and medication status. Schizophrenia Research 2005; 75: 349-62.

10. Fawzi M.H., Fawzi M.M., Khedr H.H., Fawzi M.M. Tobacco smoking in Egyptian schizophrenia patients with and without obsessive-compulsive symptoms. Schizophrenia Research 2007; 95: 236-46.

11. Tiryaki A., Ozkorumak E. Do the obsessive-compulsive symptoms have an effect in schizophrenia? Comprehensive Psychiatry 2010; 51: 357-62.

12. Whitney K.A., Fastenau P.S., Evans J.D., Lysaker P.H. Comparative neuropsychological function in obsessive-compulsive disorder and schizophrenia with and without obsessive-compulsive symptoms. Schizophrenia Research 2004; 69: 75-83.

13. Lisiecka A, Śmiarowska M, Kamiński R, Letkiewicz M, Korwin-Piotrowska K. Zespół natręctw w przebiegu schizofrenii – efektywność leczenia klomipraminą. Postępy Psychiatrii i Neurologii 2005; 14 (supl. 1/20): 81-83.

14. Lin S.K., Su S.F., Pan C.H. Higher plasma drug concentration in clozapine-treated schizophrenic patients with side effects of obsessive/compulsive symptoms. Therapeutic Drug Monitoring 2006; 28: 303-7.

15. Mahendran R., Liew E., Subramaniam M. De novo emergence of obsessive-compulsive symptoms with atypical antipsychotics in Asian patients with schizophrenia or schizoaffective disorder: a retrospective, cross-sectional study. Journal of Clinical Psychiatry 2007; 68: 542-5.

16. Sa A.R., Hounie A.G., Sampaio A.S., Arrais J., Miguel E.C., Elkis H. Obsessive-compulsive symptoms and disorder in patients with schizophrenia treated with clozapine or haloperidol. Comprehensive Psychiatry 2009; 50: 437-42.

17. Kim S.W., Shin I.S., Kim J.M., The 5-HT2 receptor profiles of antipsychotics in the pathogenesis of obsessive-compulsive symptoms in schizophrenia. Clinical Neuropharmacology 2009; 32 (4): 224-6.

18. Mukhopadhaya K., Krishnaiah R., Taye T., Nigam A., Bailey A.J., Sivakumaran T., et al. Obsessive-compulsive disorder in UK clozapine-treated schizophrenia and schizoaffective disorder: a cause for clinical concern. Journal of Psychopharmacology 2009; 23 (1): 6-13.

19. Juven-Wetzler A, Fostick L., Cwikel-Hamzany S., Balaban E., Zohar J. Treatment with Ziprasidone for schizophrenia patients with OCD. European Neuropsychopharmacology 2014; 24: 1454-1462.

20. Tibbo P., Kroetsch M., Chue P., Warneke L. Obsessive-compulsive disorder in schizophrenia. Jounal of Psychiatry Research 2000; 34: 139-46.

21. Poyurovsky M., Hramenkov S., Isakov V., Rauchverger B., ModaiI, Schneidman M., et al. Obsessive-compulsive disorder in hospitalized patients with chronic schizophrenia. Psychiatry Research 2001; 102: 49-57.

Downloads

Published

2017-01-31