Zwang und Schizophrenie

Abstract

Co-occurrence of psychotic and obsessive-compulsive symptoms has been recognized for decades. This paper reviews published reports from five perspectives: schizophrenia with obsessive-compulsive symptoms, obsessive-compulsive disorder (OCD) with psychotic symptoms, schizophrenia-spectrum-personality disorder with obsessive-compulsive symptoms, obsessive-compulsive symptoms induced by atypical antipsychotics and similarities of functional neural circuits theory in OCD and schizophrenia. A MEDLINE search was conducted to identify relevant articles from 1960 until 2004. Only a few systematic data that explore the nature and significance of such occurrence have been published. More recent studies using systematic diagnostic criteria suggest that the rate of occurrence may not be rare at all. In schizophrenia, a similar dorsolateral prefrontal cortex circuit shares anatomic substrates similar to those of the OCD orbitofrontal circuit. Exploring the interface of schizophrenic and obsessive-compulsive symptoms is important for diagnostic clarity and could have important implications for treatment and long-term prognosis. The review emphasizes the different origins and natural course of co-occurrence of schizophrenic and obsessive-compulsive symptoms and their various outcome under atypical antipsychotics and selective serotonin reuptake inhibitors (SSRI). Further double-blind, randomized, placebo-controlled investigations in larger cohorts of schizophrenic and OCD patients are needed in order to identify a schizo-obsessive schizophrenia and a schizotypal subtype of obsessive compulsive disorder and to substantiate the algorithm for treatment.

P03-63 - Frequency and severity of obsessive-compulsive symptoms/disorder, violence and suicidality in schizophrenic patients

“…[2] In multiple studies, the prevalence of obsessive compulsive symptoms (OCS) and OCD in patients with schizophrenia have been reported from 7.8 to 64 percent and from 2 to 36 percent respectively. [3][4][5][6][7][8][9][10][11][12][13] Some of these differences can be explained with regard to different diagnostic criteria, assessment methods, duration of schizophrenia, difficulty in differentiating OCS from schizophrenia symptoms and from probable side effects of atypical antipsychotics. [6][10][13] In the past, the presence of OCS was considered to be an indicator of favorable prognosis of schizophrenia.…”

Schizotypal personality disorder in clinical obsessive–compulsive disorder samples: a brief overview

“…Fifteen review articles were selected as relevant. 5,[11][12][13][14][15][16][17][18][19][20][21][22][23][24] Ten articles were rejected because they did not meet the search criteria (articles on subclinical OCS). Additionally, 25 original research articles were identified after reference cross-checking and from the 15 selected relevant review articles.…”