scholarly journals Schizophrenia-spectrum psychopathology in obsessive–compulsive disorder: an empirical study

2019 ◽  
Vol 270 (8) ◽  
pp. 993-1002 ◽  
Author(s):  
Andreas Rosén Rasmussen ◽  
Julie Nordgaard ◽  
Josef Parnas
Keyword(s):  
Diagnostic Criteria ◽  
Obsessive Compulsive Disorder ◽  
Psychotic Symptoms ◽  
Main Diagnosis ◽  
Schizophrenia Spectrum Disorders ◽  
Obsessive Compulsive ◽  
Main Research ◽  
Compulsive Disorder ◽  
Diagnostic Potential ◽  
Schizophrenia Spectrum

Abstract The differential diagnosis of obsessive–compulsive disorder (OCD) and schizophrenia-spectrum disorders can be difficult. In the current diagnostic criteria, basic concepts such as obsession and delusion overlap. This study examined lifetime schizophrenia-spectrum psychopathology, including subtle schizotypal symptomatology and subjective anomalies such as self-disorders, in a sample diagnosed with OCD in a specialized setting. The study also examined the differential diagnostic potential of the classic psychopathological notions of true obsession (‘with resistance’) and pseudo-obsession. The study involved 42 outpatients diagnosed with OCD at two clinics specialized in the treatment of OCD. The patients underwent semi-structured, narrative interviews assessing a comprehensive battery of psychopathological instruments. The final lifetime research-diagnosis was based on a consensus between a senior clinical psychiatrist and an experienced research clinician. The study found that 29% of the patients fulfilled criteria of schizophrenia or another non-affective psychosis as main, lifetime DSM-5 research-diagnosis. Another 33% received a research-diagnosis of schizotypal personality disorder, 10% a research-diagnosis of major depression and 29% a main research-diagnosis of OCD. Self-disorders aggregated in the schizophrenia-spectrum groups. True obsessions had a specificity of 93% and a sensitivity of 58% for a main diagnosis of OCD. In conclusion, a high proportion of clinically diagnosed OCD patients fulfilled diagnostic criteria of a schizophrenia-spectrum disorder. The conspicuous obsessive–compulsive symptomatology may have resulted in a disregard of psychotic symptoms and other psychopathology. Furthermore, the differentiation of obsessions from related psychopathological phenomena is insufficient and a conceptual and empirical effort in this domain is required in the future.

Variable Insight in OCD

2017 ◽  
Author(s):  
Rebecca J. Hamblin ◽  
Jennifer Moonjung Park ◽  
Monica S. Wu ◽  
Eric A. Storch
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Assessment Tools ◽  
Schizophrenia Spectrum Disorders ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Definition Of ◽  
The Relationship ◽  
Insight Into

Individuals with obsessive-compulsive disorder (OCD) often have good insight into the irrational nature of their obsessions and the excessive character of their compulsions, but insight exists along a continuum and is markedly poor in some patients. This chapter reviews the assessment and phenomenological correlates of variable insight in OCD in both pediatric and adult populations. It reviews the definition of insight and its relationship to the evolution of diagnostic criteria for obsessive-compulsive disorder, as well as the major assessment tools used to measure and quantify insight for clinical and research purposes. The relationships between insight and clinical characteristics of OCD, including symptom severity, comorbidity, and treatment response are reviewed, followed by a review of neurobiological correlates of insight and the relationship between poor insight and schizophrenia spectrum disorders.

Obsessive-compulsive disorder and schizophrenia in three identical twin pairs

1991 ◽  
Vol 21 (1) ◽  
pp. 135-141 ◽  
Author(s):  
S. W. Lewis ◽  
B. Chitkara ◽  
A. M. Revelely
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Monozygotic Twin ◽  
Schizophrenia Spectrum Disorders ◽  
Obsessive Compulsive ◽  
Schizotypal Personality ◽  
Compulsive Disorder ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Diagnostic Changes

SYNOPSISThree monozygotic twin pairs are described who are concordant for DSM-III-R obsessive-compulsive disorder while being discordant for schizophrenia or schizoaffiective disorder. Follow-up interview showed the non-psychotic co-twins to have schizotypal personality disorder. It is concluded that obsessive-compulsive and schizophrenia-spectrum disorders can truly co-exits, thus supporting diagnostic changes introduced into DSM-III-R, and may in some cases be inherited together.

scholarly journals Diagnostic validity of early-onset obsessive-compulsive disorder in the Danish Psychiatric Central Register: findings from a cohort sample

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017172 ◽  
Author(s):  
Judith Nissen ◽  
Shelagh Powell ◽  
Susanne V Koch ◽  
James J Crowley ◽  
Manuel Matthiesen ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Obsessive Compulsive Disorder ◽  
Early Onset ◽  
Primary Outcome ◽  
Child And Adolescent ◽  
Main Diagnosis ◽  
Diagnostic Validity ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Central Register

ObjectivesEmploying national registers for research purposes depends on a high diagnostic validity. The aim of the present study was to examine the diagnostic validity of recorded diagnoses of early-onset obsessive-compulsive disorder (OCD) in the Danish Psychiatric Central Register (DPCR).DesignReview of patient journals selected randomly through the DPCR.MethodOne hundred cases of OCD were randomly selected from DPCR. Using a predefined coding scheme based on the Children’s Yale Brown Obsessive Compulsive Scale (CYBOCS), experienced research nurse or child and adolescent psychiatrists assessed each journal to determine the presence/absence of OCD diagnostic criteria. The detailed assessments were reviewed by two senior child and adolescent psychiatrists to determine if diagnostic criteria were met.Primary outcome measurementsPositive predictive value (PPV) was used as the primary outcome measurement.ResultsA total of 3462 children/adolescents received an OCD diagnosis as the main diagnosis between 1 January 1995 and 31 December 2015. The average age at diagnosis was 13.21±2.89 years. The most frequent registered OCD subcode was the combined diagnosis DF42.2. Of the 100 cases we examined, 35 had at least one registered comorbidity. For OCD, the PPV was good (PPV 0.85). Excluding journals with insufficient information, the PPV was 0.96. For the subcode F42.2 the PPV was 0.77. The inter-rater reliability was 0.94. The presence of the CYBOCS in the journal significantly increased the PPV for the OCD diagnosis altogether and for the subcode DF42.2.ConclusionThe validity and reliability of International Classification of Disease 10th revision codes for OCD in the DPCR is generally high. The subcodes for predominant obsessions/predominant compulsions are less certain and should be used with caution. The results apply for both children and adolescents and for both older and more recent cases. Altogether, the study suggests that there is a high validity of the OCD diagnosis in the Danish National Registers.

Structured Interview for Hoarding Disorder (SIHD)

2019 ◽  
Vol 35 (4) ◽  
pp. 512-520
Author(s):  
Caterina Novara ◽  
Paolo Cavedini ◽  
Stella Dorz ◽  
Susanna Pardini ◽  
Claudio Sica
Keyword(s):  
Convergent Validity ◽  
Structured Interview ◽  
Diagnostic Process ◽  
Schizophrenia Spectrum Disorders ◽  
Clinical Environment ◽  
Obsessive Compulsive ◽  
Rater Reliability ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Schizophrenia Spectrum

Abstract. The Structured Interview for Hoarding Disorder (SIHD) is a semi-structured interview designed to assist clinicians in diagnosing a hoarding disorder (HD). This study aimed to validate the Italian version of the SIHD. For this purpose, its inter-rater reliability has been analyzed as well as its ability to differentiate HD from other disorders often comorbid. The sample was composed of 74 inpatients who had been diagnosed within their clinical environment: 9 with HD, 11 with obsessive-compulsive disorder (OCD) and HD, 22 with OCD, 19 with major depressive disorder (MDD), and 13 with schizophrenia spectrum disorders (SSD). The results obtained indicated “substantial” or “perfect” inter-rater reliability for all the core HD criteria, HD diagnosis, and specifiers. The SIHD differentiated between subjects suffering from and not suffering from a HD. Finally, the results indicated “good” convergent validity and high scores were shown in terms of both sensitivity and specificity for HD diagnosis. Altogether, the SIHD represents a useful instrument for evaluating the presence of HD and is a helpful tool for the clinician during the diagnostic process.

Benefit of Clomipramine-quetiapine Combination in Obsessive-compulsive Disorder with Non Response to Serotonin Selective Reuptake Inhibitors. Case Report

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
G. Marian ◽  
B. Ionescu ◽  
D. Ghinea ◽  
N. Alina
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Rating Scale ◽  
Case Series ◽  
Antidepressant Medication ◽  
Tricyclic Antidepressant ◽  
Psychotic Symptoms ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Work Related ◽  
Affective Symptoms

Background:Patients who suffer of obsessive-compulsive disorder (OCD) experience obsessive thoughts and/or urges to engage in compulsive behaviours. the condition causes severe discomfort and, in many cases, leads to serious impairment in social and work-related functioning.Although antipsychotic monotherapy has been associated with ineffectiveness and even increase of psychotic symptoms (especially in psychotic patients), antipsychotics as adjuvant to antidepressant medication have proven to be effective in several case series and pilot clinical trials.The objective of this case was to evaluate the effectiveness of clomipramine-quetiapine combination in OCD refractory to serotonin selective reuptake inhibitors treatment patient.Method:23 years unemployed male was diagnosed with OCD after 1 year from onset and received 3 trials with serotonin selective reuptake inhibitors at therapeutical doses, without any improvement and even more with worsening of affective associated symptoms. We managed this case by using a tricyclic antidepressant (clomipramine up to 100 mg/day) with an atypical antipsychotic (quetiapine up to 200 mg/day). We employed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Obsessive-Compulsive Checklist (OCC) and Hamilton Depression rating Scale (HDRS) at baseline, weekly for the first 2 months and monthly after (follow up 2 years).Results:Patient achieved a very fast and sustained improvement both in obsessive-compulsive and affective symptoms, which provided a very good social and work rehabilitation.Conclusion:Clomipramine-quetiapine combination may be a benefit for OCD refractory to serotonin selective reuptake inhibitors and a safe strategy.

An Approach to Comorbidity Between Obsessive-Compulsive Disorder and Schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. S495-S495
Author(s):  
A. Gomez Peinado ◽  
S. Cañas Fraile ◽  
P. Cano Ruiz
Keyword(s):  
Mental Health ◽  
Obsessive Compulsive Disorder ◽  
Negative Symptoms ◽  
Behavioral Therapy ◽  
Psychotic Symptoms ◽  
Simultaneous Presence ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Salud Mental ◽  
Competing Interest

IntroductionAn association has been observed between obsessive symptoms in Obsessive Compulsive Disorder (OCD) and psychotic symptoms in schizophrenia, being sometimes difficult to establish a clear limit between them. The term “schizo-obsessive disorder” was proposed to describe the resulting disorder of comorbidity of OCD and schizophrenia, although it has not been definitely settled.ObjectiveTo analyze the incidence of coexistence of OCD and schizophrenia symptoms and the way it modifies the treatment and prognosis of the illness.MethodReview of some articles published in Mental Health journals such as “Salud Mental” and “Actas Españolas de Psiquiatría”.ResultsSome studies about psychotic patients have determined 15% as the average of comorbidity of OCD and schizophrenia. The probability of having OCD is six times bigger if there is psychotic pathology associated.The fact that obsessive and psychotic symptoms get together in some patients shades the prognosis bringing more negative symptoms, more depressive humor, a larger cognitive impairment, more resistance to treatment and more relapses than we can observe in OCD and schizophrenia isolated.The pharmacological treatment usually consists in neuroleptic plus anti-obsessive drugs, together with cognitive-behavioral therapy. Sometimes, when there is a very bad evolution, it is required to consider psychosurgery as one necessary option, even though its use in this context is not much widespread.ConclusionsThe simultaneous presence of OCD and schizophrenia is more common than we could expect only by chance and makes the prognosis worse, being difficult to find a truly effective treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Effectiveness of the Inference Based Approach to Treating Obsessive-compulsive Disorder with Poor Insight; a Randomized Controlled Multicentre Trial

2017 ◽  
Vol 41 (S1) ◽  
pp. S73-S73
Author(s):  
H. Visser ◽  
H. van Megen ◽  
T. van Balkom
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Multicentre Trial ◽  
Psychological Treatment ◽  
Symptom Reduction ◽  
Main Diagnosis ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Randomized Controlled ◽  
Small Subgroup ◽  
Competing Interest

BackgroundThere is an urgent need for an effective psychological treatment for patients with obsessive compulsive disorder (OCD) with poor insight, since this disorder is associated with severe suffering and a low quality of life. The inference based approach (IBA), a new psychotherapy for OCD specifically targets insight in OCD. In a randomized controlled multicentre trial, the effectiveness of IBA was compared to the effectiveness of CBT for treating patients with OCD with poor insight. In this study, 24 sessions of IBA were tested versus 24 sessions of CBT. Ninety patients with a main diagnosis of OCD with poor insight according to the DSM-IV criteria participated in the study. The primary outcome was reduction of the obsessive-compulsive symptoms.ResultsIn both conditions, a significant OCD symptom reduction was reached, but no condition effects were established. Post hoc, in a small subgroup of patients with the worst insight (n = 23), it was found that the patients treated with the IBA reached a significantly higher OCD symptom reduction than patients treated with CBT [estimated marginal mean = –7.77, t(219.45) = –2.4, P = 0.017]. Of patients treated with IBA, 41.9% were responder and 20.9% completely recovered. Of the patients treated with CBT, 42.6% were responder and 12.8% recovered.ConclusionPatients with OCD with poor insight improve significantly after psychological treatment. The results of this study suggest that both CBT and the IBA are effective treatments for OCD with poor insight. The IBA might be more promising than CBT for patients with more extreme poor insight.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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