The concept of prodromal symptoms in schizophrenia is an old matter of debate. There have been reported several signs and symptoms that are considered to have a predictive value in a first psychotic episode, namely in the mood or anxious spectrums. However, these symptoms are not specific and can overlap with other disorders that have to be considered in the differential diagnosis.

To present a young adult with marked anxious symptoms, namely in obsessive-compulsive spectrum, and psychotic (subclinical) symptoms, questioning the extension of the comorbidity between anxious disorders and schizophrenia.

A case report is presented and a literature review of the theme is shortly surveyed.

The case report is about a 20 years old man, who have been developing for about two years obsessive thoughts of doubt concerning his sexuality, death and his mental health. Additionally, he described sensations of depersonalization, derealization and an intense distress that have been interfering with his function and daily activity. Several studies report substantial presence of anxious symptoms (including OCD symptoms) in schizophrenia, suggesting its early appearance in the development of the disease. Moreover, they can act as predictor of poorer outcome and may promote transition from psychotic symptoms to schizophrenia.

In schizophrenia prodromal stages, anxious symptoms may increase the risk and predict the development of psychosis disorder. On the other hand, the existence of mild psychotic symptoms can be present in neurotic disorders, witch compels clinicians to be cautious in the differential diagnosis that enclose these symptoms.