Dept. of Biostatistics & Medical Informatics, Cerrahpaşa Faculty of Medicine Istanbul University, Istanbul, Turkey; Dept. of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UK.
Dept. of Psychiatry, Rumeilah Hospital, Hamad Medical Corporation, Qatar.
Asian J Psychiatr. 2018 Oct;37:80-84. doi: 10.1016/j.ajp.2018.08.016. Epub 2018 Aug 18.
Psychiatric co-morbidity is a common condition, partly due to the overlap of symptoms in the categorical diagnosis of mental disorders. The co-occurrence of schizophrenia (SZ) and obsessive compulsive disorder (OCD) is a common and challenging co-morbid condition. Also, the relationship between SZ and OCD remains unclear.
The aim of this study was to describe the co-morbidity of obsessive-compulsive disorder (OCD) among schizophrenia (SZ) patients and compare clinical characteristics of schizophrenia patients with versus without comorbid OCD.
A cohort-study was carried out on 396 patients enrolled between November 2011 to June 2014 at the Department of Psychiatry, Rumeilah Hospital in Qatar. We employed the WHO Composite International Diagnostic Interview (WHO-CIDI), and Structured clinical interview for DSM-5 (SCID-5) for diagnoses, the Yale-Brown Obsessive Compulsive Scale Symptom Checklist for scoring OCD. Patients were grouped in SZ patients with and without comorbid OCD (SZ-OCD vs SZ).
396 subjects were interviewed. Age of SZ-OCD patients was 42.69 ± 14.33 (years old) whereas SZ patients without OCD ranged 41.59 ± 13.59 years old. There were statistically significant differences in clinical characteristics between SZ with and without OCD : age (p = 0.010), BMI (body mass index; p = 0.011), education (p = 0.033), employment (p = 0.019), cigarette smoking (p = 0.039), sheesha smoking (p = 0.008), and prevalence of consanguinity (p = 0.043). In particular, the rate of consanguinity in the current generation was 31.8% [95% CI = 29.1-34.7]. Also, there were statistically significant differences at Hamilton Depression score, General Health Score, Clinical Global Impression- Score, duration of illnesses, and Global Assessment of Functioning (p < 0.001). The results show that anxious, mood and psychotic dimensions rated higher among SZ - OCD ones than SZ only patients.
This study confirms that SZ-OCD is a common co-morbidity and prevalence of SZ OCD is higher among patients reporting a degree of consanguinity. Even if this condition is under-recognized in clinical practice, it may significantly change SZ presentation and outcome since psychopathological dimensions report higher scores in the co-morbidity sample.
精神共病是一种常见的情况，部分原因是精神障碍的分类诊断中症状的重叠。精神分裂症（SZ）和强迫症（OCD）共病是一种常见且具有挑战性的共病情况。此外，SZ 和 OCD 之间的关系仍不清楚。
本研究旨在描述 SZ 患者中强迫症（OCD）的共病情况，并比较伴有和不伴有 OCD 的 SZ 患者的临床特征。
这是一项队列研究，共纳入了 2011 年 11 月至 2014 年 6 月在卡塔尔鲁梅拉医院精神科就诊的 396 名患者。我们采用了世界卫生组织复合国际诊断访谈（WHO-CIDI）和 DSM-5 结构化临床访谈（SCID-5）进行诊断，采用耶鲁-布朗强迫症量表症状清单（Yale-Brown Obsessive Compulsive Scale Symptom Checklist）对 OCD 进行评分。患者被分为伴有和不伴有 OCD 的 SZ 患者（SZ-OCD 与 SZ）。
对 396 名受试者进行了访谈。SZ-OCD 患者的年龄为 42.69±14.33（岁），而无 OCD 的 SZ 患者的年龄为 41.59±13.59 岁。SZ 伴或不伴 OCD 的患者在临床特征上存在统计学显著差异：年龄（p=0.010）、BMI（体重指数；p=0.011）、教育程度（p=0.033）、就业状况（p=0.019）、吸烟（p=0.039）、水烟吸烟（p=0.008）和近亲结婚率（p=0.043）。特别是，当前一代的近亲结婚率为 31.8%[95%CI=29.1-34.7]。此外，在汉密尔顿抑郁量表评分、一般健康评分、临床总体印象评分、疾病持续时间和总体功能评估方面也存在统计学显著差异（p<0.001）。结果表明，焦虑、情绪和精神病维度在 SZ-OCD 患者中的评分高于仅 SZ 患者。
本研究证实，SZ-OCD 是一种常见的共病，在报告一定程度近亲结婚的患者中，SZ-OCD 的患病率更高。即使这种情况在临床实践中被低估，它也可能显著改变 SZ 的表现和结局，因为在共病样本中，精神病理学维度的评分更高。
