Comparison of clinical characteristics and comorbidity in schizophrenia patients with and without obsessive-compulsive disorder: schizophrenic and OC symptoms in schizophrenia.
Comparison of clinical characteristics and comorbidity in schizophrenia patients with and without obsessive-compulsive disorder: schizophrenic and OC symptoms in schizophrenia.
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DOI：
10.4088/jcp.v64n1104
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发表时间：
2003-11
期刊：
影响因子：
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通讯作者：
M. Poyurovsky;V. Kriss;G. Weisman;S. Faragian;R. Kurs;M. Schneidman;C. Fuchs;Abraham Weizman;R. Weizman
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文献类型：
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作者：
M. Poyurovsky;V. Kriss;G. Weisman;S. Faragian;R. Kurs;M. Schneidman;C. Fuchs;Abraham Weizman;R. Weizman
由于相当一部分精神分裂症患者有强迫症（OCD）的症状，我们试图提供一个强迫症精神分裂症亚组的现象学特征。方法将符合DSM-IV精神分裂症和强迫症标准的连续样本（N = 55）与55例年龄和住院次数匹配的无强迫症精神分裂症患者进行比较。使用DSM-IV轴I精神疾病的结构化临床访谈（SCID-I），包括基于DSM-IV标准的抽动障碍特定模块、阳性和阴性症状评估量表、Yale-Brown强迫量表、临床总体冲动量表和汉密尔顿抑郁评定量表。结果：强迫症患者（N = 55）的精神分裂症患者比非强迫症患者（N = 55）的积极维度得分低（p = 0.01）。确定了两个亚组的强迫症患者：强迫症独立的精神分裂症症状和强迫症部分重叠的阳性精神分裂症症状。精神分裂症合并强迫症患者有较多的强迫症谱系障碍，主要是躯体变形障碍和慢性抽动障碍。更多患有强迫症的精神分裂症患者接受附加5-羟色胺再吸收抑制剂或氯氮平治疗。结论精神分裂症伴强迫症患者与非强迫症伴精神分裂症患者在精神分裂症症状严重程度、合并强迫症谱系障碍及药物治疗方面存在差异。这些发现和2个亚组的精神分裂症强迫症患者的鉴定支持了这种独特的临床实体的有效性，并可能有助于建立精神分裂症强迫症亚型的诊断标准。
BACKGROUND Since a substantial proportion of schizophrenia patients has symptoms of obsessive-compulsive disorder (OCD), we sought to provide a phenomenological characterization of a schizophrenia subgroup with OCD. METHOD A consecutive sample of patients who met DSM-IV criteria for both schizophrenia and OCD (N = 55) was compared with 55 schizophrenia patients without OCD matched for age and number of hospitalizations. Structured Clinical Interview for DSM-IV Axis I psychiatric disorders (SCID-I), including a specific module for tic disorders based on DSM-IV criteria, Scales for the Assessment of Positive and Negative Symptoms, Yale-Brown Obsessive-Compulsive Scale, Clinical Global Impressions scale, and Hamilton Rating Scale for Depression were used. RESULTS Schizophrenia patients with OCD (N = 55) had lower positive dimension scores than schizophrenia patients without OCD (N = 55) (p =.01). Two subgroups of schizo-obsessive patients were identified: OCD independent of schizophrenia symptoms and OCD partially overlapping positive schizophrenia symptoms. Schizophrenia patients with OCD had more SCID-detectable OCD-spectrum disorder, primarily body dysmorphic disorder and chronic tic disorders. More schizophrenia patients with OCD were treated with either add-on serotonin reuptake inhibitors or clozapine. CONCLUSION Schizophrenia patients with OCD differ from their non-OCD-schizophrenia counterparts in severity of schizophrenia symptoms, co-occurrence of OCD-spectrum disorders, and pharmacotherapy. These findings and the identification of 2 subgroups of schizo-obsessive patients support the validity of this unique clinical entity and may facilitate the establishment of diagnostic criteria for a schizo-obsessive subtype of schizophrenia.