Hostname: page-component-848d4c4894-jbqgn Total loading time: 0 Render date: 2024-06-23T02:38:25.889Z Has data issue: false hasContentIssue false
  • English
  • Français

Obsessive-Compulsive Symptoms in Schizophrenia: Are They Manifestations of a Distinct Subclass of Schizophrenia?

Published online by Cambridge University Press:  07 November 2014

Ileana Berman ,
Demetra Pappas  and
Stuart M. Berman
Get access Rights & Permissions [Opens in a new window]

Abstract

The association between obsessive-compulsive (OC) symptoms and schizophrenia has been discussed in the literature for many decades. Recent studies, which have been more systematic than earlier reports and benefited from more rigorous diagnostic criteria, have generated results that contradict earlier findings. The current consensus is that OC symptoms are seen in a significant number of patients with schizophrenia, and indicate a poor prognosis. These recent studies also suggest that OC symptoms are more than just expressions of persistent schizophrenic psychosis, and that they share characteristics with obsessive-compulsive disorder (OCD). This article discusses the arguments supporting the possibility that OC symptoms are either manifestations of comorbid OCD, or are characteristics of a distinct subtype of schizophrenia.

Type
Feature Articles
Information
CNS Spectrums , Volume 2 , Issue 3: Schizophrenia & OCD: Convergence , March 1997 , pp. 45 - 48
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Stengel, E. A study of some clinical aspects of the relationship between obsessional neurosis and psychotic reaction types. J Ment Sci. 1945;91:166–187.Google Scholar
2.Rosen, I. The clinical significance of obsessions in schizophrenia. J Ment Sci. 1957;103:773–785.CrossRefGoogle ScholarPubMed
3.Fenton, WS, McGlashan, TH. The prognostic significance of obsessive-compulsive symptoms in schizophrenia. Am J Psychiatry. 1986;143:437–441.Google ScholarPubMed
4.Sullivan, HS. Clinical Studies in Psychiatry. New York, NY: WW Norton Company; 1956.Google Scholar
5.Parkin, A. Neurosis and schizophrenia: II. modern perspectives. Psychiatry Q. 1966;40:217–235.Google Scholar
6.Birnie, WA, Litman, SK. Obsessionality in schizophrenia. Can Psychiatr Assoc J. 1978;23:77–81.Google Scholar
7.Berman, I, Kalinowski, A, Berman, SM, Lengua, J, Green, AI. Obsessive and compulsive symptoms in chronic schizophrenia. Comp Psychiatry. 1995;36:6–10.CrossRefGoogle ScholarPubMed
8.Samuel, J, Nesdadt, G, Walyniec, P, Adler, L, Liong, KY, Pulver, AE. Obsessive-compulsive symptoms in schizophrenia. Schizophr Res. 1993;9:139.CrossRefGoogle Scholar
9.Bermanzohn, P, Siris, S. Comorbidity in schizophrenia. Presented at the APA Annual Meeting; 1995; Miami, Fla.Google Scholar
10.Insel, TR, Akiskal, HS. Obsessive-compulsive disorder with psychotic features: a phenomenologic analysis. Am J Psychiatry. 1986;143:1527–1533.Google ScholarPubMed
11.Berman, I, Merson, A, Viegner, B, Losonczy, MF, Pappas, D, Green, AI. Obsessions and compulsions as a distinct cluster of symptoms in schizophrenia: a neuropsychological study. In press.Google Scholar
12.Murphy, DL, Zohar, J, Bekelfat, C, et al.Obsessive-compulsive disorder as a 5-HT subsystem-related behavioral disorder. Br J Psychiatry. 1989;(suppl):5–24.Google Scholar
13.Rapoport, JL. The biology of obsessions and compulsions. Sci Am. 1989;260:83–89.Google Scholar
14.Bekelfat, C, Murphy, DL, Zohar, J, Hill, JL, Grover, G, Insel, TR. Clomipramine in obsessive-compulsive disorder: further evidence for a serotonergic mechanism of action. Arch Gen Psychiatry. 1989;45:177–185.Google Scholar
15.Hollander, E, Fay, M, Cohen, B, Campeas, R, Gorman, JM, Liebowitz, MR. Serotonergic and noradrenergic sensitivity in obsessive-compulsive disorder: behavioral findings. Am J Psychiatry. 1988;145:1015–1017.Google Scholar
16.Davila, R. Plasma HVA, neuroleptics, dopaminergic plasticity. Biol Psychiatry. 1989;25:1–3.Google Scholar
17.Davidson, M, Kahn, RS. Knott, P, et al.Effects of neuroleptic treatment on symptoms of schizophrenia and plasma homovanillic acid concentrations. Arch Gen Psychiatry. 1991;48:910–913.Google Scholar
18.Thoren, P, Asberg, M, Bertilsson, L, Mellstrom, B, Sjoqvist, F, Traskman, L. Clomipramine treatment in obsessive-compulsive disorder. Arch Gen Psychiatry. 1980;37:1289–1294.Google Scholar
19.Berman, I, Viegner, B, Merson, A, Allan, E, Pappas, D, Green, AI. Differential relationships between positive and negative symptoms and neuropsychological deficits in schizophrenia. In press.Google Scholar
20.Addington, J, Addington, D, Matika-Tyndale, E. Cognitive functioning and positive and negative symptoms in schizophrenia. Schizophrenia Res. 1991;5:123–134.Google Scholar
21.Keefe, RSE. The contribution of neuropsychology to psychiatry. Am J Psychiatry. 1995;152:6–15.Google Scholar
22.Strauss, M. Relations of symptoms to cognitive deficits in schizophrenia. Schizophrenia Bull. 1993;19:215–231.Google Scholar
23.Head, D, Bolton, D, Hymas, N. Deficit in cognitive shifting ability in patients with obsessive-compulsive disorders. Biol Psychiatry. 1989;25:929–937.Google Scholar
24.Aronowitz, B, Hollander, E, DeCaria, C, et al.Neuropsychology of obsessive-compulsive disorder: preliminary findings. Neuropsychiatry, Neuropsychology and Behavioral Neurology. 1994;7:81–86.Google Scholar
25.Christensen, KJ, Kim, SW, Dysken, MW, Hoover, KM. Neuropsychological performance in obsessive-compulsive disorder. Biol Psychiatry. 1992;31:4–18.CrossRefGoogle ScholarPubMed
26.Pato, MT, Zohar-Kadouch, R, Zohar, J, Murphy, DL. Return of symptoms after discontinuation of clomipramine in patients with obsessive-compulsive disorder. Am J Psychiatry. 1988;145:1521–1525.Google Scholar
27.Zohar, J, Kaplan, Z, Benjamin, J. Clomipramine treatment of obsessive compulsive symptomatology in schizophrenic patients. J Clin Psychiatry. 1993;54:385–388.Google Scholar
28.Berman, I, Sapers, BL, Chang, HHJ, Losonczy, MF, Schmilder, J, Green, AI. Treatment of obsessive-compulsive symptoms in schizophrenic patients with clomipramine. J Clin Psychopharmacol. 1995;15:206–210.Google Scholar
29.Barr, LC, Goodman, WK, Price, LH, McDougle, CJ, Charney, DS. The serotonin hypothesis of obsessive compulsive disorder: implication of pharmacologic challenge studies. J Clin Psychiatry. 1992;53(suppl): 17–28.Google Scholar
30.Insel, TR, Mueller, EA, Alterman, I, Linnoila, M, Murphy, DL. Obsessive-compulsive disorder and serotonin: is there a connection? Biol Psychiatry. 1985;20:1174–1188.Google Scholar
31.Hollander, E, DeCaria, CM, Nitescu, A, et al.Serotonergic function in obsessive-compulsive disorder: behavioral neuroendocrine responses to oral m-chlorophenylpiperazine and fenfluramine in patients and healthy volunteers. Arch Gen Psychiatry. 1992;49:21–28.Google Scholar
32.Bleich, A, Brown, SL, Kahn, R, van Praag, HM. The role of serotonin in schizophrenia. Schizophrenia Bull. 1988;14:297–315.Google Scholar
33.Iqbal, N, Asnis, GM, Wetzler, S, Kahn, RS, Kay, SR, van Praag, HM. The MCPP challenge test in schizophrenia: hormonal and behavioral responses. Biol Psychiatry. 1991;30:770–778.CrossRefGoogle ScholarPubMed
34.Kahn, RS, Siever, LJ, Gabriel, S, et al.Serotonin function in schizophrenia: effects of meta-chlorophenylpiperazine in schizophrenic patients and healthy subjects. Psychiatiy Res. 1992;43:1–12.Google Scholar
35.Baker, RW, Chengappa, KNR, Baird, JW, Steingard, S, Christ, MAG, Schooler, NR. Emergence of obsessive compulsive symptoms during treatment with clozapine. J Clin Psychiatry. 1992;53:439–442.Google Scholar
36.LaPorta, LD. More on obsessive-compulsive symptoms and clozapine. J Clin Psychiatry. 1994;55:312. Letter.Google Scholar
37.Patil, VJ. Development of transient obsessive-compulsive symptoms during treatment with clozapine. Am J Psychiatry. 1992;149:272. Letter.Google Scholar
38.Cohen, LJ, Hollander, E, DeCaria, CM, et al.Specificity of neuropsychological impairment in obsessive-compulsive disorder: a comparison with social phobic and normal control subjects. J Neuropsychiatry Clin Neurosci. 1996;8:82–85.Google Scholar
39.Goldberg, TE, Gold, J. Neurocognitive functioning in patients with schizophrenia. In: Bloom, F, Kupfer, D, eds. Psycho-pharmacology: The Fourth Generation of Progress. New York, NY: Raven Press; 1995;1245–1257.Google Scholar
40.Myers, JK, Weissman, MM, Tischler, GL, et al.Six-month prevalence of psychiatric disorders in three communities. Arch Gen Psychiatry. 1984;41:959–967.Google Scholar
41.McDougle, C, Goodman, WK, Leckman, JF, Price, LH. The psychopharmacology of obsessive compulsive disorder. Psychiatric Clin North Am. 1993;16:749–766.CrossRefGoogle ScholarPubMed
42.Breese, GR, Baumeister, AA, McCown, TJ, et al.Behavioral differences between neonatal and adult 6-hydroxy-dopamine-treated rats to dopamine agonists: relevance to neurological symptoms in clinical syndromes with reduced brain dopamine. J Pharmacol Exp Ther. 1984;231:343–354.Google Scholar
43.Jackson, D, Bruno, JP, Stachowiak, MK, et al.Inhibition of striatal acetylcholine release by serotonin and dopamine after the intracerebral administration of 6-hydroxy-dopamine to neonatal rats. Brain Res. 1988;457:267–273.Google Scholar