Comparison of clinical characteristics, co-morbidity and pharmacotherapy in adolescent schizophrenia patients with and without obsessive–compulsive disorder

Abstract 

A substantial proportion of adolescent schizophrenia patients exhibit obsessive–compulsive symptoms/disorder (OCS/OCD). In the present study we sought to provide a clinical characterization of adolescent schizo-obsessive patients. A consecutive sample of 22 adolescent patients (age 13–18 years) who met DSM-IV criteria for both schizophrenia and OCD was compared with 22 non-OCD schizophrenia patients matched for age, gender and number of hospitalizations. The Structured Clinical Interview for DSM-IV Axis I psychiatric disorders (SCID-I), the Scale for the Assessment of Positive (SAPS) and Negative (SANS) Symptoms, the Yale–Brown Obsessive–Compulsive Scale (Y–BOCS) and the Clinical Global Impression (CGI) were used. We found that schizo-obsessive patients had earlier age at onset of schizophrenia symptoms, had more OCD spectrum disorders, primarily tic disorders, but did not differ in severity of schizophrenia symptoms from non-OCD schizophrenia patients. In a majority of the schizo-obsessive patients, OCS preceded or co-occurred with the onset of schizophrenia and did not correlate with schizophrenic symptoms. As expected, more schizo-obsessive patients than their non-OCD counterparts were treated with adjunctive anti-obsessive agents. These findings indicate that clinical characteristics of adolescent schizo-obsessive patients are generally similar to those previously revealed in their adult counterparts. The neurobiology underlying the co-occurrence of the OC and schizophrenia symptoms merits further evaluation.

Keywords: Adolescent schizophrenia, Obsessive–compulsive symptoms, Co-morbidity, Pharmacotherapy