Obsessive-compulsive (OC) symptoms and schizophrenia may present, as intertwined phenomena whose relationship remains poorly understood. The purpose of this paper is to provide a detailed phenomenological description of OC symptoms in schizophrenia.
Fifty long-term patients with chronic schizophrenia or schizoaffective disorder from a continuing day-treatment program were assessed using the Structured Clinical Interview for DSM-IV and the Yale-Brown Obsessive-Compulsive Scale symptom checklist. Forty-six percent (n=23) reported clinically significant OC symptoms. Twenty-six percent (n=13) met criteria for OCD, from which three subgroups emerged: (1) patients whose OCD was unrelated to their psychotic symptoms, (2) patients whose OCD was related to, but not restricted to, their psychotic symptoms, and (3) patients whose OC symptoms existed on a continuum with their psychosis. The last group tended to incorporate their OC symptoms into delusional beliefs during the active phase of illness and shift to OCD during full or partial remissions. Eight percent met all inclusion criteria for OCD, but their OC symptoms were better accounted for by their psychosis.
We conclude that these findings support previous clinical constructs that OCD and schizophrenia are not always dichotomous disorders, but may be interconnected.