Childhood Obsessive-Compulsive Disorder Presenting as Schizophrenia Spectrum Disorders

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.

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Obsessive-compulsive disorder and schizophrenia in three identical twin pairs

Psychological Medicine ◽

10.1017/s0033291700014720 ◽

1991 ◽

Vol 21 (1) ◽

pp. 135-141 ◽

Cited By ~ 9

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.

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

European Archives of Psychiatry and Clinical Neuroscience ◽

10.1007/s00406-019-01022-z ◽

2019 ◽

Vol 270 (8) ◽

pp. 993-1002 ◽

Cited By ~ 7

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.

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Structured Interview for Hoarding Disorder (SIHD)

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000433 ◽

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.

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Obsessive-Compulsive Disorder With and Without Tic Disorder: A Comparative Study From India

CNS Spectrums ◽

10.1017/s1092852900013791 ◽

2008 ◽

Vol 13 (8) ◽

pp. 705-711 ◽

Cited By ~ 34

Author(s):

T.S. Jaisoorya ◽

Y.C. Janardhan Reddy ◽

S. Srinath ◽

K. Thennarasu

Keyword(s):

Obsessive Compulsive Disorder ◽

Age Of Onset ◽

Early Age ◽

Obsessive Compulsive ◽

The West ◽

Tic Disorder ◽

Compulsive Disorder ◽

Symptom Profile ◽

Spectrum Disorders ◽

Motor Tics

ABSTRACTIntroduction: Evidence from phenomenological, family, genetic, and treatment studies from Western centers have suggested that tic-related obsessive-compulsive disorder (OCD) could be different from non-tic-related OCD. This study from India investigated the differences in OCD with and without tics, with respect to sociode-mographics, symptom profile, and comorbidity, including obsessive-compulsive spectrum disorders, to examine whether the clinical profile of tic-related OCD is similar to that reported previously.Methods: Fifty subjects with OCD and tics (chronic motor tics and Tourette syndrome) were compared with 141 OCD subjects without tics.Results: Subjects having OCD with tics tended to be males, and had an earlier onset of illness. They had more of symmetry/aggressive and religious obsessions, and cleaning, ordering/arranging, hoarding, and repeating compulsions and were associated with trichotillomania and hypochondraisis. Stepwise backward (Wald) regression analysis showed that an early age of onset, male gender, aggressive obsessions, cleaning compulsions, and trichotillomania were significantly associated with tic-related OCD.Conclusion: The findings of this study from India are broadly similar to those reported previously from the West indicating the universality of differences in tic- and non-tic-related OCD. Our findings also support the existing evidence that tics contribute to the heterogeneity of OCD.

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Cigarette smoking in patients with obsessive compulsive disorder: a report from the International College of Obsessive Compulsive Spectrum Disorders (ICOCS)

CNS Spectrums ◽

10.1017/s1092852915000565 ◽

2015 ◽

Vol 20 (5) ◽

pp. 469-473 ◽

Cited By ~ 8

Author(s):

Bernardo Dell’Osso ◽

Humberto Nicolini ◽

Nuria Lanzagorta ◽

Beatrice Benatti ◽

Gregorio Spagnolin ◽

...

Keyword(s):

Cigarette Smoking ◽

Psychiatric Disorders ◽

Obsessive Compulsive Disorder ◽

Tourette’S Syndrome ◽

Obsessive Compulsive ◽

Cross Sectional ◽

Tic Disorder ◽

Compulsive Disorder ◽

International College ◽

Spectrum Disorders

Obsessive compulsive disorder (OCD) showed a lower prevalence of cigarette smoking compared to other psychiatric disorders in previous and recent reports. We assessed the prevalence and clinical correlates of the phenomenon in an international sample of 504 OCD patients recruited through the International College of Obsessive Compulsive Spectrum Disorders (ICOCS) network.Cigarette smoking showed a cross-sectional prevalence of 24.4% in the sample, with significant differences across countries. Females were more represented among smoking patients (16% vs 7%; p<.001). Patients with comorbid Tourette’s syndrome (p<.05) and tic disorder (p<.05) were also more represented among smoking subjects. Former smokers reported a higher number of suicide attempts (p<.05).We found a lower cross-sectional prevalence of smoking among OCD patients compared to findings from previous studies in patients with other psychiatric disorders but higher compared to previous and more recent OCD studies. Geographic differences were found and smoking was more common in females and comorbid Tourette’s syndrome/tic disorder.

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