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New Information on Overlapping Cases of Schizophrenia and OCD

Schizophrenia and obsessive-compulsive disorder (OCD) are well-known psychiatric conditions that typically make profound changes in the behaviors of affected individuals. Current evidence indicates that the two conditions appear together in the same people much more often than random chance would permit. In a new study, published in 2013 in the journal CNS Spectrums, a multinational research team examined the effects of overlapping symptoms of schizophrenia and OCD. The members of this team concluded that people affected by both of these disorders essentially develop a unique, distinct form of mental illness, which the researchers refer to as “schizo-OCD.”

Background Information

Schizophrenia is the most prominent form of a group of conditions commonly known as psychotic disorders (and formally known as “schizophrenia spectrum and other psychotic disorders”). Affected individuals typically develop two distinct clusters of symptoms, known by mental health professionals as “positive” and “negative” symptoms. Positive symptoms of the disorder include delusional thinking, hallucinations, thought disruption and disorganization, and changes in the normal pattern of body movement. Negative schizophrenic symptoms include emotional flatness, a decline in verbal communication, loss of the ability to plan for the future and lack of motivation or desire.

Obsessive-compulsive disorder was once considered a form of anxiety disorder, but now belongs to a newly established category called “obsessive-compulsive and related disorders,” which is viewed as closely linked to anxiety disorders. People affected by OCD classically have deeply ingrained thought fixations, known as obsessions, which cause significant mental/emotional stress. They also develop behavioral patterns, known as compulsions, which typically follow rigid rules and act as a de facto relief valve for the stress of their obsessions.

Frequency of Overlap

Roughly 1 percent of the U.S. population develops schizophrenia, and roughly 2 to 3 percent of the U.S. population develops obsessive-compulsive disorder. Since both of these conditions are fairly uncommon, one would expect that only a few people with schizophrenia would develop OCD, or vice versa. However, according to the authors of a study review published in 2009 in Psychiatric Times, anywhere from 8 percent to 26 percent of all people with schizophrenia have diagnosable cases of obsessive-compulsive disorder. In addition, anywhere from 10 percent to 52 percent of all schizophrenics have meaningful OCD symptoms, but don’t have enough of those symptoms to qualify for an official diagnosis.

New Findings

The authors of the review published in Psychiatric Times concluded that people with coexisting cases of schizophrenia and OCD have significantly worse mental health outcomes than people who have onlyschizophrenia and people who only have obsessive-compulsive disorder. Specific indications of this worsened outlook include a larger number of positive and negative schizophrenia symptoms, higher levels of mental anguish, higher degrees of daily dysfunction, greater difficulties in normal thought processing, an increased chance of experiencing symptoms of depression and an increased chance of contemplating or actually attempting suicide.

In the new study published in CNS Spectrums, researchers from Israel’s Tel Aviv University and Great Britain’s National OCD Treatment Service sought to determine whether the combined effects of schizophrenia and OCD essentially interact to create “schizo-OCD,” a distinct condition separate from either schizophrenia or OCD. In the first part of this inquiry, they asked two groups of patients—one affected only by OCD and the other affected by both OCD and schizophrenia—to perform of series of 10 everyday tasks in their home environments. The researchers then reviewed video recordings taken while each participant performed these tasks and looked for telltale signs of schizophrenia and/or OCD.

After completing their review, the researchers found that the study participants affected only by OCD and the participants affected by both OCD and schizophrenia exhibited essentially the same amount of obsessive-compulsive behavior. However, they also found that the participants affected by combined cases of schizophrenia and OCD spread out their OCD-related behaviors over a much greater number of activities than the participants who had only OCD. They attributed this tendency to a schizophrenia-related inability to stay focused on any particular task for extended amounts of time, and concluded that schizo-OCD is clearly distinguishable from separate cases of schizophrenia and obsessive-compulsive disorder.

Considerations

The authors of the study published in CNS Spectrums believe that the symptoms of other mental health conditions also likely appear in people with OCD fairly often. They also believe that their research may contribute to an improved ability to diagnose both obsessive-compulsive disorder and the additional conditions that appear in combination with OCD.

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