Schizophrenia with Obsessive-Compulsive Symptoms

Clinical and Conceptual Issues

Kim, Sung-Wan MD, PhD
Lindenmayer, Jean-Pierre MD
Hwang, Michael Y. MD

Sung-Wan Kim, MD, PhD, is an Assistant Professor, Department of Psychiatry, Chonnam National University, Korea. Jean-Pierre Lindenmayer, MD, is Clinical Director, Manhattan Psychiatric Center; and Clinical Professor of Psychiatry, New York University School of Medicine. Michael Y. Hwang, MD, is Adjunct Professor of Psychiatry, New York Medical College, F.D.R. VAMC, New York.

Address correspondence to: Michael Y. Hwang, MD, F.D.R. VAMC (116A), 2094 Albany Post Road, Montrose, NY 10548; email: [email protected].

Disclosure: Dr. Kim was funded by the grant (CRI10012-1) of the Chonnam National University Hospital Research Institute of Clinical Medicine, Republic of Korea. Dr. Lindenmayer has done contracted research for Envivo, Janssen, Roche, and Otsuka and has received royalties from Multi-Health Systems and SCI-PANSS. Dr. Hwang reports no relevant financial disclosures.

Psychiatric Annals 43(10):p 442-445, October 01, 2013. | DOI: 10.3928/00485713-20131003-04

CME Educational Objectives

Develop familiarity with the diverse pathogeneses and subtyping strategies in obsessive-compulsive schizophrenia and examine their corresponding treatment options.
Consider the use of adjunctive cognitive behavioral therapy for obsessive-compulsive disorder in clinically stable patients with schizophrenia or schizoaffective disorder.
Incorporate knowledge of the patient’s clinical history, pathogenesis and pharmaco-behavioral therapy in the development of individualized treatment strategies.

Since its debut in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR), the recognition of obsessive-compulsive disorder (OCD) as a comorbidity in schizophrenia has steadily increased to an estimated rate of 12% to 23% from less than 5% in the early 20th century. Evidence also suggests that the rates of OCD or obsessive-compulsive symptoms (OCS) vary according to the stage of psychotic illness and are perhaps more prevalent in those at high risk of developing schizophrenia.