Prevalence and clinical correlations of obsessive-compulsive symptoms in schizophrenia

Obsessive compulsive symptoms are often present in persons with schizophrenia. Adequately powered studies to evaluate the effect of such symptoms in the course of the disorder, are few.

We aimed to estimate the prevalence and type of obsessive-compulsive symptoms in persons with schizophrenia.

We evaluated 200 outpatients with schizophrenia (DSM-V) on the Positive and Negative Symptom Scale (PANSS) and the Yale Brown Obsessive Compulsive Scale (YBOCS). Participants with or without obsessive compulsive symptoms were matched on age, gender and age of onset of schizophrenia. Appropriate analysis by comparisons and correlations were performed.

Prevalence of obsessive-compulsive symptoms was 18.5% (n = 37/200). Most common obsession was contamination and compulsion was cleaning/washing with a prevalence of 51.35% and 63.33% respectively. There were no significant differences between the two groups on age, gender, marital status, residence, age of onset or total duration of illness of schizophrenia. The OC symptoms group had significantly higher general psychopathology and PANSS total scores. There was significant positive correlation between YBOCS total obsession scores (To) and total PANSS scores (r = 0.358) (p = 0.030), as well as PANSS general psychopathology subscale scores (Gt) (r = 0.395) (p = 0.016) and finally between total YBOCS scores (To + Tc) and PANSS positive subscale scores (Pt)(r = 0.344) (p = 0.037).

There was a significant subgroup of schizophrenia patients (almost one fifth) who complained of obsessive-compulsive symptoms. This group reported significantly higher general psychopathology and could thus be said to be more seriously ill, in an adequately powered cross sectional study.