Baytunca Burak, Kalyoncu Tuğba, Ozel Ismail, Erermiş Serpil, Kayahan Bülent, Öngur Dost
*Child and Adolescent Psychiatry, Erzurum Regional Training and Research Hospital, Erzurum; †Child and Adolescent Psychiatry, Tepecik Teaching and Research Hospital; ‡Department of Psychiatry, §Child and Adolescent Psychiatry, Ege University Faculty of Medicine, İzmir, Turkey; and ∥Division of Psychotic Disorders, Mclean Hospital, Harvard University, Cambridge, MA.
Clin Neuropharmacol. 2017 Nov/Dec;40(6):243-245. doi: 10.1097/WNF.0000000000000248.
Obsessive-compulsive disorder (OCD) is notably a comorbid disorder in patients with schizophrenia. This study aimed to evaluate clinical features and correlates of early onset patients with schizophrenia with OCD.
In the present study, we included 10 patients with both schizophrenia and OCD and 19 patients with schizophrenia without OCD. The mean antipsychotic doses the patients needed for treatment are standardized as chlorpromazine equivalent dose.
The mean antipsychotic doses at first episode were 491 ± 376 mg/d in schizophrenia comorbid OCD group and 290 ± 209 mg/d in the schizophrenia without OCD group (P = 0.018). This significant difference was also found for the mean doses at the assessment for the study (512.40 ± 336.22 mg/d in schizophrenia comorbid OCD and 296.05 ± 147.25 mg/d in patients with schizophrenia without OCD, P = 0.012). There was no statistical difference in the mean scores of Clinical Global Impression and Positive and Negative Syndrome Scale between schizophrenia with and without OCD group, respectively. (Clinical Global Impression: 5 ± 0.66 vs 4.36 ± 0.83, P = 0.094; Positive and Negative Syndrome Scale: 67.60 ± 11.84 vs 69.84 ± 14.62, P = 0.573).
Adolescents with schizophrenia and OCD needed more antipsychotic doses for acute exacerbation and the maintenance of reduction of psychosis severity than adolescents with only schizophrenia. We could suggest that OCD comorbidity in schizophrenia is more treatment resistant, although the severity of the schizophrenia was similar between study groups. There was no correlation between OCD and schizophrenia symptoms either.
强迫症（OCD）在精神分裂症患者中是一种显著的共病障碍。本研究旨在评估早发性精神分裂症合并强迫症患者的临床特征及相关因素。
在本研究中，我们纳入了10例同时患有精神分裂症和强迫症的患者以及19例无强迫症的精神分裂症患者。患者治疗所需的平均抗精神病药物剂量以氯丙嗪等效剂量进行标准化。
精神分裂症合并强迫症组首次发作时的平均抗精神病药物剂量为491±376mg/d，无强迫症的精神分裂症组为290±209mg/d（P = 0.018）。在研究评估时的平均剂量方面也发现了这一显著差异（精神分裂症合并强迫症组为512.40±336.22mg/d，无强迫症的精神分裂症患者为296.05±147.25mg/d，P = 0.012）。精神分裂症合并强迫症组与无强迫症组之间，临床总体印象量表和阳性与阴性症状量表的平均得分无统计学差异。（临床总体印象量表：5±0.66 vs 4.36±0.83，P = 0.094；阳性与阴性症状量表：67.60±11.84 vs 69.84±14.62，P = 0.573）。
与仅患有精神分裂症的青少年相比，患有精神分裂症和强迫症的青少年在急性加重期及维持精神病性症状严重程度减轻方面需要更多的抗精神病药物剂量。我们可以认为，尽管研究组之间精神分裂症的严重程度相似，但精神分裂症合并强迫症更具治疗抵抗性。强迫症与精神分裂症症状之间也无相关性。
