Markers of vulnerability to obsessive–compulsive disorder in an ultra‐high risk sample of patients who developed psychosis

Fontenelle, Leonardo F.; Lin, Ashleigh; Pantelis, Christos; Wood, Stephen J.; Nelson, Barnaby; Yung, Alison R.

doi:10.1111/j.1751-7893.2012.00357.x

Cited by 18 publications

(23 citation statements)

References 33 publications

(59 reference statements)

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“…A possible confounding variable may however be the higher number of patients with affective psychosis among the patients with comorbid OCD. Fontenelle et al [9] argued that depression may serve as a vulnerability marker for OCD in psychosis since patients with OCD and psychosis reported a higher rate of depressive symptoms both before and after conversion from ultra-high risk for psychosis. The increased depressive symptoms in patients with co-morbid OCD may be clinically important, given findings that people with psychotic disorders and concurrent depressive symptoms have poorer long-term functional outcomes compared to the non-depressed [34], and depressive symptoms have been found to be related to related to an increased risk of suicidality in FEP-patients [35].…”

Section: Discussionmentioning

confidence: 99%

“…Comorbid OCD is related to more impairmed social functioning [2,3] and more neurological abnormalies [4-6]. Patients with schizophrenia and comorbid OCD have been reported to have earlier onset of psychosis, and an increased rate of depressive symptoms and suicidal attempts [7-9], compared to their non-OCD counterparts. However, these patterns have not been constantly reported [10,11].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and clinical characteristics of patients with obsessive-compulsive disorder in first-episode psychosis

et al. 2013

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BackgroundObsessive-compulsive disorder (OCD) in patients with psychotic disorders has been reported to be a frequent co-morbid disorder in patients with psychotic disorders. The aim of the study determine the prevalence of OCD in first-episode psychosis and the relationship with clinical characteristics.MethodsFirst-episode psychosis patients (N = 246) consecutively admitted to a comprehensive early psychosis program were assessed for OCD with the Structured Clinical Interview for DSM-IV. Symptom assessment measures were the Positive and Negative Syndrome Scale, Global Assessment of Functioning, and the Clinician Rating Scale.ResultsTwenty-six patients (10.6%) fulfilled the criteria for OCD. Patients with comorbid OCD were younger, had more depressive symptoms and a higher rate of suicidal plans or attempts at index point compared to patients without OCD. The two groups did not differ with respect to other demographic variables or severity of psychotic symptoms.ConclusionOCD is a significant comorbid disorder in patients with first-episode psychosis. Since treatment procedures are different, systematic screening for OCD is warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence and clinical characteristics of patients with obsessive-compulsive disorder in first-episode psychosis

et al. 2013

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“…Regarding the impact of OCS during the ARMS on other clinical variables, findings have been heterogeneous. Whereas higher impairment of psychosocial functioning (de Haan et al, 2012; DeVylder et al, 2012; Fusar-Poli et al, 2012; Hur et al, 2012) and more severe depressive symptoms (Niendam et al, 2009; DeVylder et al, 2012; Fontenelle et al, 2012; de Haan et al, 2013) have consistently been reported, findings regarding transition rates into psychosis (Niendam et al, 2009; Fontenelle et al, 2011, 2012; Fusar-Poli et al, 2012) and cognition (Van Dael et al, 2011){4854}(Hur et al, 2012) are contradicting.…”

Section: Clinical Presentation and Explanatory Conceptsmentioning

confidence: 99%

“…Findings have been contradicting. Whereas some investigations did not find any significant differences (Hermesh et al, 2003; Whitney et al, 2004; Öngür and Goff, 2005; Tumkaya et al, 2009; Tiryaki and Ozkorumak, 2010; Achim et al, 2011; Meijer et al, 2013), others even suggested that OCS may be associated with better cognitive abilities (Lee et al, 2009; Borkowska et al, 2013), especially in the prodromal states of schizophrenia (Van Dael et al, 2011; Fontenelle et al, 2012; Hur et al, 2012; Zink et al, under review). Most results, however, showed more pronounced deficits in the described domains of executive functioning (Hwang et al, 2000; Lysaker et al, 2002, 2009), cognitive flexibility (Kumbhani et al, 2010; Patel et al, 2010), and also delayed visual memory (Berman et al, 1998; Schirmbeck et al, 2011).…”

Section: Clinical Presentation and Explanatory Conceptsmentioning

confidence: 99%

Comorbid obsessive-compulsive symptoms in schizophrenia: contributions of pharmacological and genetic factors

Schirmbeck¹,

Zink²

2013

Front. Pharmacol.

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A large subgroup of around 25% of schizophrenia patients suffers from obsessive-compulsive symptoms (OCS) and about 12% fulfill the diagnostic criteria of an obsessive-compulsive disorder (OCD). The additional occurrence of OCS is associated with high subjective burden of disease, additional neurocognitive impairment, poorer social and vocational functioning, greater service utilization and high levels of anxiety and depression. Comorbid patients can be assigned to heterogeneous subgroups. One hypothesis assumes that second generation antipsychotics (SGAs), most importantly clozapine, might aggravate or even induce second-onset OCS. Several arguments support this assumption, most importantly the observed chronological order of first psychotic manifestation, start of treatment with clozapine and onset of OCS. In addition, correlations between OCS-severity and dose and serum levels and duration of clozapine treatment hint toward a dose-dependent side effect. It has been hypothesized that genetic risk-factors dispose patients with schizophrenia to develop OCS. One study in a South Korean sample reported associations with polymorphisms in the gene SLC1A1 (solute carrier family 1A1) and SGA-induced OCS. However, this finding could not be replicated in European patients. Preliminary results also suggest an involvement of polymorphisms in the BDNF gene (brain-derived neurotrophic factor) and an interaction between markers of SLC1A1 and the gene DLGAP3 (disc large associated protein 3) as well as GRIN2B (N-methyl-D-aspartate receptor subunit 2B). Further research of well-defined samples, in particular studies investigating possible interactions of genetic risk-constellations and pharmacodynamic properties, are needed to clarify the assumed development of SGA-induced OCS. Results might improve pathogenic concepts and facilitate the definition of at risk populations, early detection and monitoring of OCS as well as multimodal therapeutic interventions.

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“…Depression, cognitive impairments, anxiety, and cannabis abuse are frequently observed in UHR individuals,41 thus several studies are trying to correlate the incidence of these comorbid signs with the risk of developing psychosis 42–43. Some psychopathological features of UHR subjects (eg, obsessive–compulsive behavior, cognitive deficits) have already been identified as promising markers of specific trajectories in the evolution of prodromal symptoms 44–46. On the other hand, comorbidity often constitutes a confounding variable when assessing the risk of developing psychosis in the clinical practice 47…”

Section: Prediction Strategiesmentioning

confidence: 99%

Prediction and prevention of the first psychotic episode: new directions and opportunities

Piras

Casu

et al. 2014

TCRM

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In the last few decades, substantial research has focused on the possibility of early detection and prevention of the first psychotic episode in young individuals at risk of developing this mental disturbance; however, unresolved clinical and ethical issues still call for further investigations. New perspectives and opportunities may come from the identification of selective psychopathological and instrumental markers linking the appearance of subtle psychotic symptoms with the clinical outcome of specific mental pathologies. Furthermore, empirically derived algorithms and risk staging models should facilitate the identification of targeted prevention therapies, possibly improving the efficacy of well-tolerated therapeutic approaches, such as psychological interventions and natural compound supplementations. To date, the collected evidence on the efficacy and tolerability of pharmacological prevention therapies raises more doubts than hopes. A very early detection of risk and appropriate symptomatic pattern classifications may provide a chance to better match prevention strategies with the development of psychosis.

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Markers of vulnerability to obsessive–compulsive disorder in an ultra‐high risk sample of patients who developed psychosis

Abstract: Although depression and a family history of anxiety disorder may act as vulnerability markers for OCD in psychosis, the resulting anxiety may be a correlate or a consequence of PSY + OCD.

Cited by 18 publications

References 33 publications

Prevalence and clinical characteristics of patients with obsessive-compulsive disorder in first-episode psychosis

Prevalence and clinical characteristics of patients with obsessive-compulsive disorder in first-episode psychosis

Comorbid obsessive-compulsive symptoms in schizophrenia: contributions of pharmacological and genetic factors

Prediction and prevention of the first psychotic episode: new directions and opportunities

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