Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Dept. of Psychiatry, NHIS Ilsan Hospital, Goyang-si, Gyeonggi-do, Korea.
Asian J Psychiatr. 2020 Apr;50:101991. doi: 10.1016/j.ajp.2020.101991. Epub 2020 Feb 27.
Obsessive-compulsive symptoms (OCS) commonly occur in the course of schizophrenia. The aim of this study was to investigate the rate of obsessive-compulsive disorder (OCD) in patients with chronic schizophrenia and evaluate lifetime correlates of the comorbidity. Subjects were clinically stable patients with chronic schizophrenia (n = 320). Patients having comorbid OCD and those without OCD were compared in terms of symptoms dimensions and cognitive function. OCD was found in 20.6 % of subjects. Earlier age at onset, male gender, higher level of education, comorbid panic disorder, and specific phobia were associated with comorbid OCD. In terms of lifetime symptoms, depression (p = 0.001) and anxiety (p = 0.014) showed significant association with the comorbidity, which corroborates with our previous study findings regarding OCD in bipolar disorder. In addition, decreased emotional response (p = 0.016), less formal thought disorder (p = 0.007), and less prodromal impairment (p = 0.005) were independently associated with the comorbidity. The OCD group showed better performance in working memory domain (p = 0.027) while other cognitive domains did not show any significant difference between the two groups. Association of OCSs with depressive symptoms and other comorbid anxiety disorders seems to be a common finding across schizophrenia and bipolar disorder. This study also suggests that comorbidity of OCD in schizophrenia is associated with less impairment of thought process and cognitive function throughout the disease course.
强迫症症状(OCS)在精神分裂症的病程中很常见。本研究旨在调查慢性精神分裂症患者中强迫症(OCD)的发生率,并评估共病的终身相关性。研究对象为临床稳定的慢性精神分裂症患者(n=320)。对合并 OCD 和未合并 OCD 的患者进行了症状维度和认知功能方面的比较。结果发现,20.6%的患者患有 OCD。发病年龄较早、男性、受教育程度较高、合并惊恐障碍和特定恐惧症与合并 OCD 相关。在终身症状方面,抑郁(p=0.001)和焦虑(p=0.014)与共病显著相关,这与我们之前关于双相情感障碍中 OCD 的研究结果一致。此外,情绪反应减少(p=0.016)、思维形式障碍减轻(p=0.007)和前驱损害减少(p=0.005)与共病独立相关。OCD 组在工作记忆域表现更好(p=0.027),而其他认知域在两组之间没有显著差异。OCSs 与抑郁症状和其他共病焦虑障碍之间的关联似乎是精神分裂症和双相情感障碍的共同发现。本研究还表明,精神分裂症中 OCD 的共病与整个病程中思维过程和认知功能的损害程度较轻有关。