Rajkumar Ravi Philip, Reddy Y C Janardhan, Kandavel Thennarasu
Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
Compr Psychiatry. 2008 May-Jun;49(3):262-8. doi: 10.1016/j.comppsych.2007.09.006. Epub 2007 Dec 20.
Obsessive-compulsive disorder (OCD) is a common comorbid condition in schizophrenia. The clinical implications of this comorbidity are uncertain. There is some evidence to suggest that schizophrenia with OCD (schizo-obsessive) has a poor prognosis, but the effect of OCD on schizophrenia symptom profile is unclear. Therefore, we studied the clinical profile of schizophrenic patients with and without comorbid OCD. Fifty consecutive patients who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for both schizophrenia and OCD and an equal number of schizophrenic patients without OCD were recruited over a period of 12 months from the clinical services of the National Institute of Mental Health and Neuro Sciences, Bangalore, India. Their clinical profile was systematically assessed and compared to detect significant differences, if any. Schizo-obsessive patients were more likely to have paranoid symptoms and first-rank symptoms of schizophrenia. They had lower anergia, higher depression scores, more comorbid personality disorders, and somewhat lesser disability. Significant correlations were observed between the Yale-Brown Obsessive-Compulsive Scale scores (including the Yale-Brown Obsessive-Compulsive Scale insight score) and schizophrenia symptom dimension scores. Our findings are concordant with the hypothesis that "schizo-obsessive" schizophrenia may be a distinct subtype with unique clinical characteristics, supporting the need for further research in this area.
强迫症（OCD）是精神分裂症中一种常见的共病情况。这种共病的临床意义尚不确定。有一些证据表明，伴有强迫症的精神分裂症（精神分裂症 - 强迫症）预后较差，但强迫症对精神分裂症症状谱的影响尚不清楚。因此，我们研究了伴有和不伴有共病强迫症的精神分裂症患者的临床特征。在12个月的时间里，从印度班加罗尔国家心理健康和神经科学研究所的临床服务中招募了50名连续符合《精神障碍诊断与统计手册》第四版精神分裂症和强迫症标准的患者，以及同等数量的无强迫症的精神分裂症患者。对他们的临床特征进行了系统评估和比较，以检测是否存在显著差异。精神分裂症 - 强迫症患者更有可能出现偏执症状和精神分裂症的一级症状。他们的无活力程度较低，抑郁得分较高，共病的人格障碍更多，残疾程度稍轻。耶鲁 - 布朗强迫症量表评分（包括耶鲁 - 布朗强迫症量表自知力评分）与精神分裂症症状维度评分之间存在显著相关性。我们的研究结果与“精神分裂症 - 强迫症”精神分裂症可能是一种具有独特临床特征的独特亚型这一假设一致，支持在该领域进行进一步研究的必要性。
