Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-05-07T18:48:14.627Z Has data issue: false hasContentIssue false

Demographics, Prevalence, and Clinical Features of the Schizo-obsessive Subtype of Schizophrenia

Published online by Cambridge University Press:  07 November 2014

Abstract

The schizo-obsessive subtype of schizophrenia has been proposed to describe the condition of patients with chronic psychotic disorders and prominent obsessive-compulsive (OC) symptoms. These patients differ from others with schizophrenia not only in their psychopathology, but perhaps also in their prognosis and pharmacotherapeutic response. Potent serotonin reuptake blockers, such as clomipramine, fluvoxamine, andfluoxetine, in conjunction with antipsychotics, can prove helpful in improving these patients' OC symptoms. The current study to access the demographics, prevalence, and clinical features of the schizo-obsessive subtype included established outpatients with a principal diagnosis of schizophrenia or schizoaffective disorder treated at a large urban public hospital. More than 50% of the hospital's psychiatric population is Hispanic. The Modified Maudsley Obsessive Compulsive Inventory (MMOCI) was used to identify prominent compulsive symptoms. Of the 52 patients who fulfilled the specific screening criteria, 17 (33%) also had prominent OC symptoms. Surprisingly, there was a statistical trend (P=0.06) for Hispanic patients to meet our threshold for the schizo-obsessive subtype. The MMOCI proved to be an adequate and efficient self-rated screening tool. The prevalence of the schizo-obsessive subtype, especially among Hispanic patients, highlights the importance for mental health professionals working with this population to identify and appropriately treat this group of patients.

Type
Feature Articles—Original Research
Copyright
Copyright © Cambridge University Press 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
2.Goodman, WK, Price, LH, Rassmussen, SA, et al.The Yale-Brown Obsessive-Compulsive Scale. Arch Gen Psychiatry. 1989;46:10011006.Google ScholarPubMed
3.Porto, L, Bermanzohn, PC, Pollack, S, et al.A profile of obsessive-compulsive symptoms in schizophrenia. CNS Spectrum. 1997;2:2125.CrossRefGoogle Scholar
4.Yaryura-Tobias, JA, Stevens, KP, Neziroglu, F, et al.Obsessive-compulsive disorder and schizophrenia: a phenomenological perspective of shared pathology. CNS Spectrum. 1997;2:2125.CrossRefGoogle Scholar
5.Zohar, J. Is there room for a new diagnostic subtype - the schizo-obsessive subtype? CNS Spectrum. 1997;2:4950.CrossRefGoogle Scholar
6.Fenton, WS, McGlashan, TH. The prognostic significance of obsessive-compulsive symptoms in schizophrenia. Am J Psychiatry. 1986;143:437441.Google ScholarPubMed
7.Cassaro, G, Pini, S, Saetton, M, et al.Occurrence and clinical correlates of psychiatric comorbidity in patients with psychotic disorders. J Clin Psychiatry. 1998;59:6068.CrossRefGoogle Scholar
8.Zohar, J, Sasson, Y, Chopra, M, et al.Schizo-obsessive subtype: obsessions and delusions. CNS Spectrums. 1998;3:3839.CrossRefGoogle Scholar
9.Blanc, R, Newman, S, Orn, H. Schizophrenia: lifetime comorbidity in a community sample. Acta Psychiatr Scand. 1987;75:383391.Google Scholar
10.Yaryura-Tobias, JA, Neziroglu, MA, Bergman, L. Clomipramine for obsessive-compulsive neurosis: an organic approach. Curr Ther Res Clin Exp. 1976;20:541548.Google Scholar
11.Zohar, J, Kaplan, Z, Benjamin, J. Clomipramine treatment of obsessive compulsive symptomatology in schizophrenic patients. J Clin Psychiatry. 1993;54:385388.Google ScholarPubMed
12.Berman, I, Sapers, BL, Chang, HH, et al.Treatment of obsessive-compulsive symptoms in schizophrenic patients with clomipramine. J Clin Psychopharmacol. 1995;15:206210.CrossRefGoogle ScholarPubMed
13.Kay, SR, Fizbein, A., Opler, LA. The positive and negative symptom scale (PANSS) for Schizophrenia. Schizophr Bull. 1987;13;261276.CrossRefGoogle ScholarPubMed
14.Pulman, J, Yassa, R, Anath, J. Clomipramine treatment of repetitive behavior. Can J Psychiatry. 1984;29:254255.CrossRefGoogle ScholarPubMed
15.Bark, N, Lindenmayer, JP. Ineffectiveness of clomipramine for obsessive compulsive symptoms in a patient with schizophrenia. Am J Psychiatry. 1992;149:136137.Google Scholar
16.Sasson, Y, Bermanzohn, PC, Zohar, J. Treatment of obsessive-compulsive syndromes in schizophrenia. CNS Spectrum. 1997;2:3445.CrossRefGoogle Scholar
17.Dominguez, RA. Treatment of obsessive-compulsive disorder in adults. In: Rush, AJ, ed. Mood and Anxiety Disorders. Philadelphia, Pa: Williams & Wilkins; 1998:250272.Google Scholar
18.Tejera, CA, Mayerhoff, DJ, Safferman, AZ, et al.Fluoxetine for obsessional symptoms in schizophrenia. Am J Psychiatry. 1994;151:149150.Google ScholarPubMed
19.Cassady, SL, Thaker, GK. Addition of fluoxetine to clozapine. Am J Psychiatry. 1992;149:1274.Google ScholarPubMed
20.Reznik, I, Sirota, P. Combined fluvoxamine and neuroleptic therapy for schizophrenic patients with obsessive compulsive disorder. Isr J Psychiatry Relat Sci. 1996;33:269270.Google Scholar
21.Baker, RW. Fluoxetine and schizophrenia in a patient with obsessional thinking. J Neuropsychiatry Clin Neurosci. 1992;4:232233.CrossRefGoogle Scholar
22.Baker, RW, Bermanzohn, PC, Wirshing, DA, et al.Obsessions, compulsions, clozapine, and risperidone. CNS Spectrums. 1997;2:2636.CrossRefGoogle Scholar
23.Dodt, JE, Byerly, MJ, Cuadros, C, et al.Treatment of risperidone-induced obsessive-compulsive symptoms with sertraline. Am J Psychiatry. 1997;154:582.Google ScholarPubMed
24.Kopala, A, Horner, HG. Risperidone, serotonergic mechanisms, and obsessive-compulsive symptoms in schizophrenia. Am J Psychiatry. 1994;151:17141715.Google ScholarPubMed
25.Baker, RW, Chengappa, KNR, Baird, JW, et al.Emergence of obsessive-compulsive symptoms during treatment with clozapine. J Clin Psychiatry. 1992;53:439442.Google ScholarPubMed
26.Ravizza, L, Barzega, G, Bellino, S, et al.Therapeutic effect and safety of adjunctive risperidone in refractory obsessive-compulsive disorder. Psychopharmacol Bull. 1996;32:677682.Google ScholarPubMed
27.Ghaemi, SN, Zarate, CA, Popli, AP, et al.Is there a relationship between clozapine and obsessive-compulsive disorder? A retrospective chart review. Compr Psychiatry. 1995;36:267270.CrossRefGoogle Scholar
28.Baker, RW, Ames, D, Umbricht, DS, et al.Obsessive-compulsive symptoms in schizophrenia: a comparison of olanzepine and placebo. Psychopharmacol Bull. 1996;32:8993.Google Scholar
29.Dominguez, RA, Jacobson, AF, de la Gandara, J, et al.Drug response assessed by the Modified Maudsley Obsessive Compulsive Inventory. Psychopharmacol Bull. 1989;2:215218.Google Scholar
30.Jacobsen, FM. Risperidone in the treatment of affective illness and obsessive-compulsive disorder. J Clin Psychiatry. 1995;56:423429.Google ScholarPubMed
31.Berigan, TR, Harazin, JS. Response to risperidone addition in fluvoxamine-refractory obsessive-compulsive disorder: three cases. J Clin Psychiatry. 1996;57:594595.CrossRefGoogle ScholarPubMed
32.Jenike, MA. Epidemiology and clinical features of obsessive-compulsive disorder. In: Jenike, MA, Baer, L, Minichiello, WE, eds. Obsessive Compulsive Disorders: Theory and Management. Littleton, Mass: PSG Publishing Co; 1986:2344.Google Scholar