Obsessive-Compulsive Symptoms and Positive, Negative, and Depressive Symptoms in Patients with Recent-Onset Schizophrenic Disorders

Objectives: To study the relation between obsessive-compulsive symptoms (OCS) and positive, negative, and depressive symptoms in patients with recent-onset schizophrenic disorders. Methods: We undertook a prospective study of 113 consecutively hospitalized patients with recent-onset schizophrenia or related disorders diagnosed according to DSM-IV criteria. We compared 3 subgroups: one without comorbid OCS, one with OCS not fulfilling DSM-IV criteria for obsessive-compulsive disorder (OCD), and one with comorbid OCD diagnosed according to DSM-IV criteria. We assessed OCS severity at admission and 6 weeks thereafter with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The Positive and Negative Syndrome Scale (PANSS) and the Montgomery–Asberg Depression Rating Scale (MADRS) were independently administered. Results: At admission, patients with schizophrenic disorders and OCD had higher mean MADRS scores than both other groups; patients with OCS not fulfilling DSM-IV criteria for OCD had lower mean PANSS negative subscale scores than both other groups. After 6 weeks, there were no significant between-group differences, and OCS severity remained constant. Conclusions: Acute patients with recent-onset schizophrenia and OCD have more severe depressive symptoms but do differ in negative symptoms, compared with patients without comorbid OCD. Mild OCS may be related to less severe negative symptoms. During regular inpatient treatment, OCS severity remains constant.

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Bipolar Disorder (BD) and Obsessive Compulsive Disorder (OCD) Comorbidty or Varied Episodes in the Same Disorder

European Psychiatry ◽

10.1016/s0924-9338(09)70830-2 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

E. Oral ◽

E. Ozan ◽

E. Deveci ◽

N. Aydın ◽

I. Kirpinar

Keyword(s):

Bipolar Disorder ◽

Depressive Symptoms ◽

Lithium Carbonate ◽

Treatment Resistant ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Compulsive Disorder ◽

Manic Symptoms ◽

Episodic Course ◽

Depressive Episodes

Previous studies have suggested that OCD has comorbidity with bipolar disorder (BD) (1,2). We evaluated the three bipolar OCD cases.C1: Because of the OCD symptoms Chlomipramine was started. Her OCD symptoms improved in several days but manic symptoms was apeeared, switched to Lithium Carbonate. In her out patient exams, manic and obsessive compulsive symptoms were almost never observed simultaneously at the course.C2: In 2003, her complaints started as combined OCD and Manic symptoms, Risperidon and Lithium carbonate were started, manic and OCD symptoms improved. In 2005, OCD and Depressive symptoms appeared together. She got improved with Lithium Carbonate and Chlomipramine. She had one episode with obsessive and manic symptoms or obsessive and depressive symptoms every year till now. Her uncle had Depression and her aunt had Bipolar disorder.C3: Because of his OCD symptoms we prescribed SSRI and lower dose antipsychotic. At that time he hospitalized for his manic symptoms, his OCD was partially remitted. His manic symptoms improved with Lithium carbonate1200p/d. He had resistant obsessive compulsive symptoms and episodic manic symptoms. His father had M. Depressive episodes.Conclusion:Our cases suggest that bipolar OCD has episodic course, treatment resistant symtomatology, high family loading and high frequency of recurrence.

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Duration of untreated illness and outcome of obsessive-compulsive disorder: A naturalistic follow-up study

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.247 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S323-S323

Author(s):

V. Prisco ◽

F. Perris ◽

T. Iannaccone ◽

M. Fabrazzo ◽

F. Catapano

Keyword(s):

Obsessive Compulsive Disorder ◽

Rating Scale ◽

Clinical Interview ◽

Obsessive Compulsive ◽

Long Term Outcome ◽

Compulsive Disorder ◽

Duration Of Untreated Illness ◽

Poor Outcome ◽

Axis I ◽

Dsm Iv

Duration of untreated illness (DUI) is a predictor of outcome in psychotic and affective disorders. Data available on DUI and its relationship with outcome in obsessive-compulsive disorder (OCD) suggest an association between longer DUI and poorer treatment response. The present study investigated socio-demographic and clinical predictors of DUI and its association with long-term outcome in OCD patients. Eighty-three OCD outpatients were treated with serotonin reuptake inhibitors (SRIs) and prospectively followed-up for 3 years. Baseline information was collected on demographic and clinical characteristics using standard assessments. Each patient was assessed through the structured clinical interview for DSM-IV axis I disorders (SCID-I), the structured clinical interview for DSM-IV axis II personality disorders (SCID-II), the Yale-Brown obsessive–compulsive scale (Y-BOCS) and the 17-item Hamilton rating scale for depression (HDRS). The DUI was explored by interviewing patients, family caregivers and clinicians. OCD subjects had a mean DUI of 7.3 (5.8) years. A younger age at onset and a greater severity of OCD symptoms at baseline were associated with a longer DUI. The DUI of patients with a “good outcome” was shorter than that of patients with a “poor outcome”. Logistic regression analysis revealed indeed a possible association between longer DUI and “poor outcome”. In the logistic multivariable model, the association of DUI with treatment outcome held true whilst controlling for socio-demographic and clinical variables.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Schizophrenia with Co-morbid Obsessive-Compulsive Disorder: A Case Series

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i34b31849 ◽

2021 ◽

pp. 69-74

Author(s):

Prakash B. Behere ◽

Pooja Raikar ◽

Debolina Chowdhury ◽

Aniruddh P. Behere ◽

Richa Yadav

Keyword(s):

Obsessive Compulsive Disorder ◽

Selective Serotonin Reuptake Inhibitors ◽

Negative Symptoms ◽

Age Of Onset ◽

Case Series ◽

Post Traumatic Stress ◽

Obsessive Compulsive ◽

Course Of Illness ◽

Obsessive Compulsive Symptoms ◽

Compulsive Disorder

The frequency of co-morbidities like Obsessive Compulsive Disorder (OCD) is common in schizophrenia. Some studies have reported earlier age of onset, more positive and negative symptoms, more depressive symptoms, and worse prognosis in such patients. The phenomenology and management of OCD in schizophrenia is understudied. Evidence claims that the course of illness of both schizophrenia and bipolar disorders may be affected by obsessive-compulsive disorder whereas in other cases antipsychotic induced obsessive-compulsive symptoms have been observed. A meta-analysis of of schizophrenia and its co-morbid psychiatric conditions, found a prevalence of 12.1% for obsessive compulsive disorder, 9.8% for panic disorders, 12.4% for post-traumatic stress disorder and 14.9% for social phobia. SGAs like amisulpride and aripiprazole are found to be useful in the treatment of comorbid OCD in schizophrenia due to their negligible serotonergic properties. A combination of selective serotonin reuptake inhibitors (SSRI) with antipsychotics has been recommended by the American Psychiatric Association (APA) for treatment of comorbid OCD in schizophrenia. Escitalopram at a dose of 20 mg/day has been found to be beneficial in such cases while psychosis worsened with the use of fluvoxamine and clomipramine. Below is a series of seven cases of schizophrenia with co-morbid obsessive-compulsive symptoms who are on treatment for their illness from the psychiatric outpatient department of a rural hospital in central India.

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A comparison of the symptomatic profile between two consecutive depressive episodes in patients with bipolar disorder type I

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2010.00496.x ◽

2010 ◽

Vol 22 (6) ◽

pp. 280-283 ◽

Cited By ~ 1

Author(s):

Marcia B De Macedo-Soares ◽

Elisa Brietzke ◽

Rodrigo Da Silva Dias ◽

Tiago Mendonça ◽

Camila Moreira ◽

...

Keyword(s):

Bipolar Disorder ◽

Depressive Symptoms ◽

Rating Scale ◽

Type I ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Paranoid Symptoms ◽

Loss Of Appetite ◽

Depressive Episodes ◽

Disorder Type

de Macedo-Soares MB, Brietzke E, da Silva Dias R, Mendonca T, Moreira C, Lafer B. A comparison of the symptomatic profile between two consecutive depressive episodes in patients with bipolar disorder type I.Objective:To compare the variability of patterns of depressive symptoms between two consecutive depressive episodes in patients with bipolar disorder type I.Methods:Review of prospectively collected data from 136 subjects of an out-patient bipolar unit from 1997 to 2007. Binomial statistics was used for the analysis of Hamilton Depression Rating Scale (HDRS)-31 items of the first and second episodes, and the correlation of the HDRS-31 item scores of both episodes was determined using the Spearman coefficient.Results:Ten depressive symptoms showed a significant correlation between index and subsequent episodes: psychological anxiety, somatic anxiety, somatic symptoms, diurnal variation, paranoid symptoms, obsessive and compulsive symptoms, hypersomnia, loss of appetite and helplessness. Only four symptoms were stable in both statistical tests: paranoid symptoms, obsessive–compulsive symptoms, loss of appetite and hypersomnia.Conclusions:Paranoid and obsessive–compulsive symptoms, loss of appetite and hypersomnia tended to be found in successive episodes. However, the moderate correlations of the symptoms across two depressive recurrences suggested that clinical presentations in bipolar depression may not be predicted by symptom profiles presented in previous episodes.

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Clinical subtypes of obsessive-compulsive disorder based on the presence of checking and washing compulsions

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462005000300008 ◽

2005 ◽

Vol 27 (3) ◽

pp. 201-207 ◽

Cited By ~ 10

Author(s):

Leonardo F Fontenelle ◽

Mauro V Mendlowicz ◽

Marcio Versiani

Keyword(s):

Obsessive Compulsive Disorder ◽

Rating Scale ◽

Empirical Support ◽

Categorical Variables ◽

Obsessive Compulsive ◽

Chi Square ◽

Obsessive Compulsive Symptoms ◽

Compulsive Disorder ◽

Significant Difference ◽

Chi Square Tests

OBJECTIVE: We aimed at examining the utility of checking and washing compulsions as markers of valid subtypes of obsessive-compulsive disorder (OCD). METHODS: One hundred and six patients with obsessive-compulsive disorder were evaluated with a socio-demographic and clinical questionnaire, the Structured Clinical Interview for DSM-IV, the Yale-Brown Obsessive-Compulsive Scale, the Clinical Global Impression, the Beck Depression Inventory, the Hamilton Rating Scale for Depression, and the Global Assessment of Functioning. These individuals were allocated in one of four subgroups [checkers (OCD-Ch; n = 20), washers (OCD-Wa; n = 13), checkers and washers (OCD-CW; n = 48), and non-checkers and non-washers (OCD non-CW = 25)] on the basis of the presence and the clinical relevance of checking and/or washing compulsive behaviors across their lifetime. Socio-demographic and clinical variables were compared and contrasted between the groups by means of ANOVA followed by post-hoc Least Significant Difference or Dunnett's tests for continuous variables and chi-square tests followed by partitioned chi-square tests for categorical variables. RESULTS: OCD-Ch and OCD-Wa did not differ on most demographic and clinical features, the only exception being the number of different types of obsessions, which were significantly higher in the former group. The OCD-CW group was more likely to exhibit an insidious onset of obsessive-compulsive symptoms, to manifest itself as a mixed subtype of obsessive-compulsive disorder and to display obsessions with contamination themes. On the other hand, the OCD non-CW group was more likely to exhibit an acute onset, a shorter duration of illness, obsessions with religious themes, an episodic course, and less severe obsessive-compulsive symptoms. CONCLUSIONS: In our sample, the probing of the presence of checking and/or washing compulsions has provided significant empirical support to establish valid subtypes of obsessive-compulsive disorder.

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The Relationship of Meta-Worry and Intolerance of Uncertainty With Pathological Worry, Anxiety, and Depression

Behaviour Change ◽

10.1375/bech.28.4.165 ◽

2011 ◽

Vol 28 (4) ◽

pp. 165-180 ◽

Cited By ~ 18

Author(s):

Nigar G. Khawaja ◽

Janette McMahon

Keyword(s):

Depressive Symptoms ◽

Social Phobia ◽

Obsessive Compulsive Disorder ◽

Intolerance Of Uncertainty ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Compulsive Disorder ◽

Assessment And Treatment ◽

Pathological Worry ◽

Relationship Of

AbstractThis study explored how meta-worry and intolerance of uncertainty relate to pathological worry, generalised anxiety, obsessive–compulsive disorder, social phobia, and depression. University students (n = 253)completed a questionnaire battery. A series of regression analyses were conducted. The results indicated that meta-worry was associated with GAD, social phobia, obsessive–compulsive, and depressive symptoms. Intolerance of uncertainty was related to GAD, social phobia, and obsessive–compulsive symptoms, but not depressive symptoms. The importance of meta-worry and intolerance of uncertainty as predictors of pathological worry, GAD, social phobia, obsessive–compulsive and depressive symptoms was also examined. Even though both factors significantly predicted the aforementioned symptoms, meta-worry emerged as a stronger predictor of GAD and obsessive compulsive symptoms than did intolerance of uncertainty. Intolerance of uncertainty, compared with meta-worry, appeared as a stronger predictor of social phobia symptoms. Findings emphasise the importance of addressing meta-worry and/or intolerance of uncertainty not only for the assessment and treatment of generalised anxiety disorder (GAD), but also obsessive–compulsive disorder, social phobia, and depression.

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Cognitive–behavioural therapy augments the effects of deep brain stimulation in obsessive–compulsive disorder

Psychological Medicine ◽

10.1017/s0033291714000956 ◽

2014 ◽

Vol 44 (16) ◽

pp. 3515-3522 ◽

Cited By ~ 38

Author(s):

M. Mantione ◽

D. H. Nieman ◽

M. Figee ◽

D. Denys

Keyword(s):

Depressive Symptoms ◽

Deep Brain Stimulation ◽

Nucleus Accumbens ◽

Behavioural Therapy ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Compulsive Disorder ◽

Cognitive Behavioural ◽

Treatment Refractory ◽

Deep Brain

Background.Deep brain stimulation (DBS) is a promising new treatment for patients with treatment-refractory obsessive–compulsive disorder (OCD). However, since most DBS patients only show a partial response, the treatment still needs to be improved. In this study we hypothesized that cognitive–behavioural therapy (CBT) could optimize the post-operative management in DBS and we evaluated the efficacy of CBT as augmentation to DBS targeted at the nucleus accumbens.Method.A total of 16 patients with treatment-refractory OCD were treated with DBS targeted at the nucleus accumbens. After stabilization of decline in OCD symptoms, a standardized 24-week CBT treatment programme was added to DBS in an open-phase trial of 8 months. Changes in obsessive–compulsive, anxiety and depressive symptoms were evaluated using the Yale–Brown Obsessive Compulsive Scale, Hamilton Anxiety Scale and Hamilton Rating Scale for Depression.Results.Following the addition of CBT to DBS, a significant decrease in obsessive–compulsive symptoms was observed, but not in anxiety and depressive symptoms. In a subsequent double-blind phase, in which stimulation was discontinued, OCD symptoms returned to baseline (relapse) and anxiety and depressive symptoms worsened (rebound) compared with baseline.Conclusions.The results of this explorative study suggest that a combined treatment of accumbens DBS and CBT may be optimal for improving obsessive–compulsive symptoms in treatment-refractory OCD. However, a subsequent randomized controlled trial is necessary to draw firm conclusions. It seems that DBS results in affective changes that may be required to enable response prevention in CBT. This may indicate that DBS and CBT act as two complementary treatments.

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Prevalence of anxiety and depressive symptoms in men with erectile dysfunction

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v11i2.101 ◽

2005 ◽

Vol 11 (2) ◽

pp. 6

Author(s):

K Pankhurst ◽

G Joubert ◽

P J Pretorius

Keyword(s):

Erectile Dysfunction ◽

Depressive Symptoms ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

Rating Scale ◽

Prescription Medication ◽

Medical Conditions ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Co Morbidity

Objectives. To determine the prevalence of anxiety and depressive symptoms in men presenting to a sexual dysfunction clinic in Bloemfontein with erectile dysfunction (ED); to determine the relationship, if any, between age and mood/anxiety symptoms in such patients; and to make clinicians aware of the co-morbidity of anxiety/mood symptoms and ED.Methods. An observational analytical study was undertaken of 100 consecutive male patients of all ages presenting with ED (with a score less than 20 on the 5-item intensity scale for ED). Age, race, marital and employment status were noted as well as social habits including smoking and alcohol use. The presence of known medical conditions and surgical procedures was ascertained. All current prescription medication was recorded. Panic disorder, obsessive-compulsive disorder, generalised anxiety disorder and social phobia were rated using the Mini International Neuropsychiatric Interview, while the Hamilton Rating Scale for Depression was used to rate depressive symptoms.Results. Thirty-three per cent of respondents had depressive symptoms, and of this group 36% had a co-morbid anxiety disorder. In total, 21% of patients had an anxiety disorder. Anxiety disorders were more common with moderate to severe ED. No anxiety disorders occurred in patients with mild ED. The majority of participants suffering from severe ED were evenly spread in age from 30 to 69 years. Participants suffering from moderate to severe ED were more likely to have medical conditions, most notably hypertension.Conclusion. The results of this study suggest that men suffering from ED are likely to have a co-morbid psychiatric disorder (42%), with the prevalence of depressive symptoms (33%) and anxiety disorders (21%) being higher than in the general population. Significant concomitant medical conditions (most notably hypertension) were more common in men with moderate to severe ED.

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Bipolar Disorder (BD) and Obsessive Compulsive Disorder (OCD) Comorbidty or Varied Episodes in the Same Disorder

European Psychiatry ◽

10.1016/s0924-9338(09)70594-2 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

E. Oral ◽

E. Ozan ◽

E. Deveci ◽

N. Aydın ◽

I. Kirpinar

Keyword(s):

Bipolar Disorder ◽

Depressive Symptoms ◽

Lithium Carbonate ◽

Treatment Resistant ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Compulsive Disorder ◽

Manic Symptoms ◽

Episodic Course ◽

Depressive Episodes

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Specialised in-patient treatment for severe, chronic, resistant obsessive–compulsive disorder

Psychiatric Bulletin ◽

10.1192/pb.bp.105.007609 ◽

2007 ◽

Vol 31 (2) ◽

pp. 49-52 ◽

Cited By ~ 12

Author(s):

Lynne M. Drummond ◽

Anusha Pillay ◽

Peter Kolb ◽

Shashi Rani

Keyword(s):

Depressive Symptoms ◽

Obsessive Compulsive Disorder ◽

Self Report ◽

Patient Treatment ◽

Clinical Implications ◽

Naturalistic Study ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Compulsive Disorder ◽

The Mean

Aims and MethodA naturalistic study was conducted to examine the outcome on self-report and observer-rated measures in patients with severe, chronic, resistant obsessive–compulsive disorder (OCD) admitted to a specialised in-patient unit.ResultsTwenty-six patients were admitted over the study period. The mean age of all patients was 37 years (s.d.=13.8, range 18–61 years) and they had a mean duration of OCD of 18.4 years (s.d.=10.9, range 4–40 years). Instruments measuring severity demonstrated a 37–67% reduction in obsessive–compulsive symptoms and a 64% reduction in depressive symptoms after an average of almost 15 weeks in hospital.Clinical ImplicationsThis study demonstrates that specialised in-patient care can benefit a small group of severely ill patients with OCD who fail to respond to treatment in primary and secondary care.

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