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Schizo-obsessive spectrum disorders: an update

  • Estêvão Scotti-Muzzi (a1) and Osvaldo Luis Saide (a1)


The presence of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorders (OCD) in schizophrenia is frequent, and a new clinical entity has been proposed for those who show the dual diagnosis: the schizo-obsessive disorder. This review scrutinizes the literature across the main academic databases, and provides an update on different aspects of schizo-obsessive spectrum disorders, which include schizophrenia, schizotypal personality disorder (SPD) with OCD, OCD with poor insight, schizophrenia with OCS, and schizophrenia with OCD (schizo-obsessive disorder). An epidemiological discussion on the discrepancies observed in the prevalence of OCS and OCD in schizophrenia across time is provided, followed by an overview of the main clinical and phenomenological features of the disorder in comparison to the primary conditions under a spectral perspective. An updated and comparative analysis of the main genetic, neurobiological, neurocognitive, and pharmacological treatment aspects for the schizo-obsessive spectrum is provided, and a discussion on endophenotypic markers is introduced in order to better understand its substrate. There is sufficient evidence in the literature to demonstrate the clinical relevance of the schizo-obsessive spectrum, although little is known about the neurobiology, genetics, and neurocognitive aspects of these groups. The pharmacological treatment of these patients is still challenging, and efforts to search for possible specific endophenotypic markers would open new avenues in the knowledge of schizo-obsessive spectrum.


Corresponding author

*Address for correspondence: Estêvão Scotti-Muzzi, MD, Psychiatry Unit, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Boulevard 28 de Setembro, 77 - Vila Isabel, Rio de Janeiro - RJ, 20551-900, Brazil. (Email:


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We are deeply indebted to the staff and colleagues from the Psychiatric Unit of the State University of Rio de Janeiro, in particular to Prof. Max de Carvalho for his helpful comments on the dissertation written by ESM and supervised by OLS.



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1. Jablensky, A. Schizophrenia: the epiemiological horizon. In: Hirsch SR, Weinberger DR, eds. Schizophrenia. Vol. 1. Oxford, UK: Blackwell; 1995: 206252.
2. Bloch, MH, Landeros-Weisenberger, A, Kelmendi, B, Coric, V, Bracken, MB, Leckman, JF. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry. 2006; 11(7): 622632.
3. Berrios, GE. Obsessive–compulsive disorder: its conceptual history in France during the 19th century. Compr Psychiatry. 1989; 30(4): 283295.
4. Fenton, WS, McGlashan, TH. The prognostic significance of obsessive–compulsive symptoms in schizophrenia. Am J Psychiatry. 1986; 143(4): 437441.
5. Schirmbeck, F, Zink, M. Comorbid obsessive-compulsive symptoms in schizophrenia: contributions of pharmacological and genetic factors. Front Pharmacol. 2013; 4: 99.
6. Hwang, MY, Opler, LA. Schizophrenia with obsessive-compulsive features: assessment and treatment. Psychiatric Annals. 1994; 24(9): 468472.
7. Hwang, MY, Morgan, JE, Losconzcy, MF. Clinical and neuropsychological profiles of obsessive-compulsive schizophrenia: a pilot study. J Neuropsychiatry Clin Neurosci. 2000; 12(1): 9194.
8. Bottas, A, Cooke, RG, Richter, MA. Comorbidity and pathophysiology of obsessive–compulsive disorder in schizophrenia: is there evidence for a schizo-obsessive subtype of schizophrenia? J Psychiatry Neurosci. 2005; 30(3): 187193.
9. Reznik, I, Kotler, M, Weizman, A. Obsessive and compulsive symptoms in schizophrenia patients—from neuropsychology to clinical typology and classification. J Neuropsychiatry Clin Neurosci. 2005; 17(2): 254255.
10. Poyurovsky, M, Koran, LM. Obsessive–compulsive disorder (OCD) with schizotypy vs. schizophrenia with OCD: diagnostic dilemmas and therapeutic implications. J Psychiatr Res. 2005; 39(4): 399408.
11. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.
12. Phillips, KA, Stein, DJ, Rauch, S, et al. Should an obsessive-compulsive spectrum grouping of disorders be included in DSM-V? Depress Anxiety. 2010; 27(6): 528555.
13. Tumkaya, S, Karadag, F, Oguzhanoglu, NK, O et al. Schizophrenia with obsessive-compulsive disorder and obsessive-compulsive disorder with poor insight: a neuropsychological comparison. Psychiatry Res. 2009; 165(1–2): 3846.
14. Catapano, F, Perris, F, Fabrazzo, M, et al. Obsessive-compulsive disorder with poor insight: a three-year prospective study. Prog Neuropsychopharmacol Biol Psychiatry. 2010; 34(2): 323330.
15. Poyurovsky, M, Zohar, J, Glick, I, et al. Obsessive-compulsive symptoms in schizophrenia: implications for future psychiatric classifications. Compr Psychiatry. 2012; 53(5): 480483.
16. Murphy, DL, Timpano, KR, Wheaton, MG, Greenberg, BD, Miguel, EC. Obsessive-compulsive disorder and its related disorders: a reappraisal of obsessive-compulsive spectrum concepts. Dialogues Clin Neurosci. 2010; 12(1): 131148.
17. de Haan, L, Dudek-Hodge, C, Verhoeven, Y, Denys, D. Prevalence of psychotic disorders in patients with obsessive-compulsive disorder. CNS Spectr. 2009; 14(8): 415417.
18. Jacob, ML, Larson, MJ, Storch, EA. Insight in adults with obsessive–compulsive disorder. Compr Psychiatry. 2014; 55(4): 896903.
19. Meier, SM, Petersen, L, Pedersen, MG, et al. Obsessive-compulsive disorder as a risk factor for schizophrenia: a nationwide study. JAMA Psychiatry. 2014; 71(11): 12151221.
20. Fontenelle, LF, Lin, A, Pantelis, C, Wood, SJ, Nelson, B, Yung, AR. A longitudinal study of obsessive-compulsive disorder in individuals at ultra-high risk for psychosis. J Psychiatr Res. 2011; 45(9): 11401145.
21. Fontenelle, LF, Lin, A, Pantelis, C, Wood, SJ, Nelson, B, Yung, AR. Markers of vulnerability to obsessive-compulsive disorder in an ultra-high risk sample of patients who developed psychosis. Early Interv Psychiatry. 2012; 6(2): 201206.
22. Zink, M, Schirmbeck, MF, Rausch, F, et al. Obsessive–compulsive symptoms in at-risk mental states for psychosis: associations with clinical impairment and cognitive function. Acta Psychiatr Scand. 2014; 130(3): 214216.
23. Achim, AM, Maziade, M, Raymond, E, Olivier, D, Mérette, C, Roy, MA. How prevalent are anxiety disorders in schizophrenia? A meta-analysis and critical review on a significant association. Schizophr Bull. 2011; 37(4): 811821.
24. Buckley, PF, Miller, BJ, Lehrer, DS, Castle, DJ. Psychiatric comorbidities and schizophrenia. Schizophr Bull. 2009; 35(2): 383402.
25. Rosen, I. The clinical significance of obsessions in schizophrenia. Br J Psychiatry. 1957; 103(433): 778785.
26. Berman, I, Kalinowski, A, Berman, SM, Lengua, J, Green, AI. Obsessive and compulsive symptoms in schizophrenia. Compr Psychiatry. 1995; 36(1): 610.
27. Lysaker, PH, Marks, KA, Picone, JB, Rollins, AL, Fastenau, PS, Bond, GR. Obsessive and compulsive symptoms in schizophrenia: clinical and neurocognitive correlates. J Nerv Ment Dis. 2000; 188(2): 7883.
28. Oulis, P, Konstantakopoulos, G, Lykouras, L, Michalopoulou, PG. Differential diagnosis of obsessive-compulsive symptoms from delusions in schizophrenia: a phenomenological approach. World J Psychiatry. 2013; 3(3): 5056.
29. Matsunaga, H, Kiriike, N, Matsui, T, et al. Obsessive-compulsive disorder with poor insight. Compr Psychiatry. 2002; 43(2): 150157.
30. Frías, A, Palma, C, Farriol, N, Salvador, A, Bonet, J, Bernáldez, I. Psychopathology and quality of life among patients with comorbidity between schizophrenia spectrum disorder and obsessive-compulsive disorder: no evidence for a “schizo-obsessive” subtype. Compr Psychiatry. 2014; 55(5): 11651173.
31. Poyurovsky, M, Faragian, S, Pashinian, A, et al. Clinical characteristics of schizotypal-related obsessive-compulsive disorder. Psychiatry Res. 2008; 159(1–2): 254258.
32. Brakoulias, V, Starcevic, V, Berle, D, et al. The clinical characteristics of obsessive compulsive disorders associated with high levels of schizotypy. Aust N Z J Psychiatry. 2014; 48(9): 852860.
33. Solem, S, Hagen, K, Wenaas, C, et al. Psychotic and schizotypal symptoms in nonpsychotic patients with obsessive-compulsive disorder. BMC Psychiatry. 2015; 15: 121.
34. Melca, IA, Yücel, M, Mendlowicz, MV, de Oliveira-Souza, R, Fontenelle, LF. The correlates of obsessive–compulsive, schizotypal, and borderlinepersonality disorders in obsessive–compulsive disorder. J Anxiety Disord. 2015; 33: 1524.
35. Frost, RO, Steketee, G, Williams, LF, Warren, R. Mood, personality disorder symptoms and disability in obsessive compulsive hoarders: a comparison with clinical and nonclinical controls. BehavRes Ther. 2000; 38(11): 10711081.
36. Rasmussen, J, Steketee, G, Silverman, M, Wilhelm, S. The relationship of hoarding symptoms to schizotypal personality and cognitive schemas in an OCD sample. J Cogn Psychother. 2013; 27(4): 384396.
37. Kashyap, H, Kumar, JK, Kandavel, T, Reddy, YCJ. Neuropsychological correlates of insight in obessive compulsive disorder. Acta Psychiatr Scand. 2012; 126(2): 106114.
38. Kashyap, H, Kumar, JK, Kandavel, T, Reddy, YCJ. The dysfunctional inner mirror: poor insight in obsessive compulsive disorder, contributions to heterogeneity and outcome. CNS Spectr. 2015; 20(5): 460462.
39. Catapano, F, Sperandeo, R, Perris, F, Lanzro, M, Maj, M. Insight and resistance in patients with obsessive-compulsive disorder. Psychopathology. 2001; 34(2): 6268.
40. Zohar, J. Is there room for a new diagnostic subtype—the schizo-obsessive subtype? CNS Spectr. 1997; 2(3): 4950.
41. Kayahan, B, Ozturk, O, Veznedaroglu, B, Eraslan, D. Obsessive-compulsive symptoms in schizophrenia: prevalence and clinical correlates. Psychiatry Clin Neurosci. 2005; 59(3): 291295.
42. Öngür, D, Goff, DC. Obsessive–compulsive symptoms in schizophrenia: associated clinical features, cognitive function and medication status. Schizophr Res. 2005; 75(2–3): 349362.
43. Poyurovsky, M, Kriss, V, Weisman, G, et al. Comparison of clinical characteristics and comorbidity in schizophrenia patients with and without obsessive-compulsive disorder: schizophrenic and OC symptoms in schizophrenia. J Clin Psychiatry. 2003; 64(11): 13001307.
44. Tiryaki, A, Özkorumak, E. Do the obsessive-compulsive symptoms have an effect in schizophrenia? Compr Psychiatry. 2010; 51(4): 357362.
45. Lysaker, PH, Bryson, GJ, Marks, KA, Greig, TC, Bell, MD. Association of obsessions and compulsions in schizophrenia with neurocognition and negative symptoms. J Neuropsychiatry Clin Neurosci. 2002; 14(4): 449453.
46. Tibbo, P, Kroetsch, M, Chue, P, Warneke, L. Obsessive compulsive disorder in schizophrenia. J Psychiatr Res. 2000; 34(2): 139146.
47. Lysaker, PH, Whitney, KA. Obsessive-compulsive symptoms in schizophrenia: prevalence, correlates and treatment. Expert Rev Neurother. 2009; 9(1): 99107.
48. Niendam, TA, Berzak, J, Cannon, TD, Bearden, CE. Obsessive compulsive symptoms in the psychosis prodrome: correlates of clinical and functional outcome. Schizophr Res. 2009; 108(1–3): 170175.
49. Faragian, S, Pashinian, A, Fuchs, C, Poyurovsky, M. Obsessive–compulsive symptom dimensions in schizophrenia patients with comorbid obsessive–compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2009; 33(6): 10091012.
50. Faragian, S, Fuchs, C, Pashinian, A, Weizman, R, Weizman, A, Poyurovsky, M. Age-of-onset of schizophrenic and obsessive-compulsive symptoms in patients with schizo-obsessive disorder. Psychiatry Res. 2012; 197(1–2): 1922.
51. Rajkumar, RP, Reddy, YC, Kandavel, T. Clinical profile of “schizo-obsessive” disorder: a comparative study. Compr Psychiatry. 2008; 49(3): 262268.
52. Poyurovsky, M, Hramenkov, S, Isakov, V, et al. Obsessive-compulsive disorder in hospitalized patients with chronic schizophrenia. Psychiatry Res. 2001; 102(1): 4957.
53. Poyurovsky, M, Kriss, V, Weisman, G, et al. Familial aggregation of schizophrenia-spectrum disorders and obsessive-compulsive associated disorders in schizophrenia probands with and without OCD. Am J Med Genet B Neuropsychiatr Genet. 2005; 133B(1): 3166.
54. Hur, JW, Shin, NY, Jang, JH, et al. Clinical and neurocognitive profiles of subjects at high risk for psychosis with and without obsessive-compulsive symptoms. Aust N Z J Psychiatry. 2012; 46(2): 161169.
55. de Haan, L, Sterk, B, van der Valk, R. Presence of obsessive compulsive symptoms in first-episode schizophrenia or related disorders is associated with subjective well-being and quality of life. Early Interv Psychiatry. 2013; 7(3): 285290.
56. De Vylder, JE, Oh, AJ, Ben-David, S, Azimov, N, Harkavy-Friedman, JM, Corcoran, CM. Obsessive compulsive symptoms in individuals at clinical risk for psychosis: association with depressive symptoms and suicidal ideation. Schizophr Res. 2012; 140(1–3): 110113.
57. Weinberger, DR. From neuropathology to neurodevelopment. Lancet. 1995; 346(8974): 552557.
58. Cummings, JL. Frontal–subcortical circuits and human behaviour. Arch Neurol. 1993; 50(8): 873880.
59. Weinberger, DR, Egan, MF, Bertolino, A, et al. Prefrontal neurons and the genetics of schizophrenia. Biol Psychiatry. 2001; 50(11): 825844.
60. Saxena, S, Brody, AL, Schwartz, JM, Baxter, R. Neuroimaging and frontal-subcortical circuitry in obsessive-compulsive disorder. Br J Psychiatry Suppl. 1998;(35): 2637.
61. Cavallaro, R, Cavedini, P, Mistretta, P, et al. Basal-corticofrontal circuits in schizophrenia and obsessive-compulsive disorder: a controlled, double dissociation study. Biol Psychiatry. 2003; 54(4): 437443.
62. Li, X, Branch, CA, Nierenberg, J. Disturbed functional connectivity of cortical activation during semantic discrimination in patients with schizophrenia and subjects at genetic high-risk. Brain Imaging Behav. 2010; 4(1): 109120.
63. Bleich-Cohen, M, Sharon, H, Weizman, R, Poyurovsky, M, Faragian, S, Hendler, T. Diminished language lateralization in schizophrenia corresponds to impaired inter-hemispheric functional connectivity. Schizophr Res. 2012; 134(2–3): 131136.
64. Aoyama, F, Iida, J, Inoue, M, et al. Brain imaging in childhood- and adolescence-onset schizophrenia associated with obsessive-compulsive symptoms. Acta Psychiatr Scand. 2000; 102(1): 3237.
65. Kwon, JS, Shin, YW, Kim, CW, et al. Similarity and disparity of obsessive compulsive disorder and schizophrenia in MR volumetric abnormalities of the hippocampus-amygdala complex. J Neurol Neurosurg Psychiatry. 2003; 74(7): 962964.
66. Kim, JJ, Youn, T, Lee, JM, Kim, IY, Kim, SI, Kwon, JS. Morphometric abnormality of the insula in schizophrenia: a comparison with obsessive–compulsive disorder and normal control using MRI. Schizophr Res. 2003; 60(2–3): 191198.
67. Ha, TH, Yoon, U, Lee, KJ, et al. Fractal dimension of cerebral cortical surface in schizophrenia and obsessive–compulsive disorder. Neurosci Lett. 2005; 384(1–2): 172176.
68. Benkelfat, C, Murphy, DL, Zohar, J, Hill, JL, Grover, G, Insel, TR. Clomipramine in obsessive-compulsive disorder: further evidence for a serotonergic mechanism of action. Arch Gen Psychiatry. 1989; 46(1): 2328.
69. Zohar, J, Insel, TR. Obsessive-compulsive disorder: psychobiological approaches to diagnosis, treatment, and pathophysiology. Biol Psychiatry. 1987; 22(6): 667687.
70. Ma, N, Tan, LW, Wang, Q, Li, ZX, Li, LJ. Lower levels of whole blood serotonin in obsessive-compulsive disorder and in schizophrenia with obsessive-compulsive symptoms. Psychiatry Res. 2007; 150(1): 6169.
71. Asami, T, Whitford, TJ, Bouix, S, et al. Globally and locally reduced MRI gray matter volumes in neuroleptic-naive men with schizotypal personality disorder: association with negative symptoms. JAMA Psychiatry. 2013; 70(4): 361372.
72. Harris, CL, Dinn, WM. Subtyping obsessive-compulsive disorder: neuropsychological correlates. Behav Neurol. 2003; 14(3–4): 7587.
73. Shin, NY, Lee, AR, Park, HY, et al. Impact of coexistent schizotypal personality traits on frontal lobe function in obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2008; 32(2): 472478.
74. Huang, LC, Hwang, TJ, Huang, GH, Hwu, HG. Outcome of severe obsessive-compulsive disorder with schizotypal features: a pilot study. J Formos Med Assoc. 2011; 110(2): 8592.
75. Aigner, M, Zitterl, W, Prayer, D, et al. Magnetic resonance imaging in patients with obsessive-compulsive disorder with good versus poor insight. Psychiatry Res. 2005; 140(2): 173179.
76. Levine, JB, Gruber, SA, Baird, AA, Yurgelun-Todd, D. Obsessive–compulsive disorder among schizophrenic patients: an exploratory study using functional magnetic resonance imaging data. Compr Psychiatry. 1998; 39(5): 308311.
77. Bleich-Cohen, M, Hendler, T, Weizman, R, Faragian, S. Working memory dysfunction in schizophrenia patients with obsessive- compulsive symptoms: an fMRI study. Eur Psychiatry. 2014; 29(3): 160166.
78. Barch, DM, Ceaser, A. Cognition in schizophrenia: core psychological and neural mechanisms. Trends Cogn Sci. 2012; 16(1): 2734.
79. Chamberlain, SR, Blackwell, AD, Fineberg, NA, Robbins, TW, Sahakian, BJ. The neuropsychology of obsessive compulsive disorder: the importance of failures in cognitive and behavioural inhibition as candidate endophenotypic markers. Neurosci Biobehav Rev. 2005; 29(3): 399419.
80. Bleich-Cohen, M, Jamshy, S, Sharon, H, et al. Machine learning fMRI classifier delineates subgroups of schizophrenia patients. Schizophr Res. 2014; 160(1–3): 196200.
81. Bleich-Cohen, M, Poyurovsky, M, Hendler, T, Weizman, R, Sharon, H. Does co-morbid obsessive–compulsive disorder modify the abnormal language processing in schizophrenia patients? An fMRI study. Front Hum Neurosci. 2014; 8: 560.
82. Hashim, HM, Fawzy, N, Fawzi, MM, Karam, RA. Brain-derived neurotrophic factor Val66Met polymorphism and obsessive-compulsive symptoms in Egyptian schizophrenia patients. J Psychiatr Res. 2012; 46(6): 762766.
83. Kwon, JS, Joo, YH, Nam, HJ, et al. Association of the glutamate transporter gene SLC1A1 with atypical antipsychotics-induced obsessive-compulsive symptoms. Arch Gen Psychiatry. 2009; 66(11): 12331241.
84. Arnold, PD, Sicard, T, Burroughs, E, Richter, MA, Kennedy, JL. Glutamate transporter gene SLC1A1 associated with obsessive-compulsive disorder. Arch Gen Psychiatry. 2006; 63(7): 769776.
85. Deng, X, Shibata, H, Takeuchi, N, et al. Association study of polymorphisms in the glutamate transporter genes SLC1A1, SLC1A3, and SLC1A6 with schizophrenia. Am J Med Genet B Neuropsychiatr Genet. 2007; 144B(3): 271278.
86. Cai, J, Zhang, W, Lu, W, et al. Influence of polymorphisms in genes SLC1A1, GRIN2B, and GRIK2 on clozapine-induced obsessive-compulsive symptoms. Psychopharmacology (Berl). 2013; 230(1): 4955.
87. Pantelis, C, Maruff, P. The cognitive neuropsychiatric approach to investigating the neurobiology of schizophrenia and other disorders. J. Psychosom Res. 2002; 53(2): 655664.
88. Pallanti, S, Castellini, G, Chamberlain, S, Quercioli, L, Zaccara, C, Fineberg, NA. Cognitive event-related potentials differentiate schizophrenia with obsessive compulsive disorder (schizo-OCD) from OCD and schizophrenia without OC symptoms. Psychiatry Res. 2009; 170(1): 5260.
89. Donchin, E, Coles, MHG. Is the P300 component a manifestation of context updating? Behav Brain Sci. 1988; 11(3): 357374.
90. Roth, WT, Cannon, EH. Some features of the auditory evoked response in schizophrenics. Arch Gen Psychiatry. 1972; 27(4): 466471.
91. Romani, A, Merello, S, Gozzoli, L, Zerbi, F, Grassi, M, Cosi, V. P300 and CT scan in patients with chronic schizophrenia. Br J Psychiatry. 1987; 151(4): 506513.
92. McCarley, RW, Shenton, ME, O’Donnell, BF, et al. Auditory P300 abnormalities and left posterior superior temporal gyrus volume reduction in schizophrenia. Arch Gen Psychiatry. 1993; 50(3): 190197.
93. Frangou, S, Sharma, T, Alarcon, G, Sigmudsson, T, Takei, N, Binnie, C. The Maudsley Family Study, II. Endogenous event-related potentials in familial schizophrenia. Schizophr Res. 1997; 23(1): 4553.
94. Bahramali, H, Gordon, E, Li, WM, Rennie, C, Wright, J, Meares, R. Fast and slow reaction times and associated ERPs in patients with schizophrenia and controls. Int J Neurosci. 1998; 95(3–4): 155165.
95. Frodl-Bauch, T, Gallinat, J, Meisenzahl, EM, Möller, HJ, Hegerl, U. P300 subcomponents reflect different aspects of psychopathology in schizophrenia. Biol Psychiatry. 1999; 45(1): 116126.
96. Mathalon, DH, Ford, JM, Rosenbloom, M, Pfefferbaum, A. P300 reduction and prolongation with illness duration in schizophrenia. Biol Psychiatry. 2000; 47(5): 413427.
97. Martin-Loeches, M, Molina, V, Muñoz, F, et al. P300 amplitude as a possible correlate of frontal degeneration in schizophrenia. Schizophr Res. 2001; 49(1–2): 121128.
98. Bramon, E, Rabe-Hesketh, S, Sham, P, Murray, R, Frangou, S. Meta-analysis of the P300 and P50 waveforms in schizophrenia. Schizophr Res. 2004; 70(2–3): 315329.
99. Abramovitch, A, Abramowitz, JS, Mittelman, A. The neuropsychology of adult obsessive–compulsive disorder: a meta-analysis. Clin Psychol Rev. 2013; 33(8): 11631171.
100. Rosell, DR, Futterman, SE, McMaster, A, Siever, LJ. Schizotypal personality disorder: a current review. Curr Psychiatry Rep. 2014; 16(7): 452.
101. Mitropoulou, V, Harvey, PD, Maldari, LA, et al. Neuropsychological performance in schizotypal personality disorder: evidence regarding diagnostic specificity. Biol Psychiatry. 2002; 52(12): 11751182.
102. Kitis, A, Akdede, BBK, Alptekin, K, et al. Cognitive dysfunctions in patients with obsessive–compulsive disorder compared to the patients with schizophrenia: relation to overvalued ideas. Prog Neuropsychopharmacol Biol Psychiatry. 2007; 31(1): 254261.
103. Meijer, JH, Swets, M, Keeman, S, Nieman, DH, Meijer, CJ, GROUP Investigators. Is a schizo-obsessive subtype associated with cognitive impairment? Results from a large cross-sectional study in patients with psychosis and their unaffected relatives. J Nerv Ment Dis. 2013; 201(1): 3035.
104. Borkowska, A, Pilaczyñska, E, Rybakowski, JK. The frontal lobe neuropsychological tests in patients with schizophrenia and/or obsessive-compulsive disorder. J Neuropsychiatry Clin Neurosci. 2003; 15(3): 359362.
105. Lee, MJ, Shin, YB, Sunwoo, YK, et al. Comparative analysis of cognitive function in schizophrenia with and without obsessive compulsive disorder. Psychiatry Investig. 2009; 6(4): 286293.
106. Berman, I, Merson, A, Viegner, B, Losonczy, MF, Pappas, D, Green, AI. Obsessions and compulsions as a distinct cluster of symptoms in schizophrenia: a neuropsychological study. J Nerv Ment Dis. 1998; 186(3): 150156.
107. Lysaker, PH, Whitney, KA, Davis, LW. Associations of executive function with concurrent and prospective reports of obsessive–compulsive symptoms in schizophrenia. J Neuropsychiatry Clin Neurosci. 2009; 21(1): 3842.
108. Patel, DD, Laws, KR, Padhi, A, et al. The neuropsychology of the schizo-obsessive subtype of schizophrenia: a new analysis. Psychol Med. 2010; 40(6): 921933.
109. Schirmbeck, F, Rausch, F, Englisch, S, et al. Stable cognitive deficits in schizophrenia patients with comorbid obsessive-compulsive symptoms: a 12-month longitudinal study. Schizophrenia Bull. 2013; 39(6): 12611271.
110. Kumbhani, SR, Roth, RM, Kruck, CL, Flashman, LA, McAllister, TW. Nonclinical obsessive-compulsive symptoms and executive functions in schizophrenia. J Neuropsychiatry Clin Neurosci. 2010; 22(3): 304312.
111. Michalopoulou, PG, Konstantakopoulos, G, Typaldou, M, et al. Can cognitive deficits differentiate between schizophrenia with and without obsessive–compulsive symptoms? Compr Psychiatry. 2014; 55(4): 10151021.
112. Ntouros, E, Bozikas, VP, Andreou, C, Kourbetis, D, Lavrentiadis, G, Garyfallos, G. Emotional perception and theory of mind in first episode psychosis: the role of obsessive–compulsive symptomatology. Psychiatry Res. 2014; 220(1–2): 112117.
113. Hermesh, H, Weizman, A, Gur, S, et al. Alternation learning in OCD/schizophrenia patients. Eur Neuropsychopharmacol. 2003; 13(2): 8791.
114. Kim, M, Kang, S, Youn, T, Kang, D, Kim, J, Kwon, JS. Neuropsychological correlates of P300 abnormalities in patients with schizophrenia and obsessive–compulsive disorder. Psychiatry Res. 2003; 123(2): 109123.
115. Frangou, S. Snipping at the endophenotypic space. Am J Psychiatry. 2013; 170(11): 12231225.
116. Gottesman, II, Gould, TD. The endophenotype concept in psychiatry: etymology and strategic intentions. Am J Psychiatry. 2003; 160(4): 636645.
117. Docherty, AR, Coleman, MJ, Tu, X, Deutsch, CK, Mendell, NR, Levy, DL. Comparison of putative intermediate phenotypes in schizophrenia patients with and without obsessive-compulsive disorder: examining evidence for the schizo-obsessive subtype. Schizophr Res. 2012; 140(1–3): 8386.
118. Allen, AJ, Griss, ME, Folley, BS, Hawkins, KA, Pearlson, GD. Endophenotypes in schizophrenia: a selective review. Schizophr Res. 2009; 109(1–3): 2437.
119. Menzies, L, Achard, S, Chamberlain, SR, et al. Neurocognitive endophenotypes of obsessive–compulsive disorder. Brain. 2007; 130(Pt 12): 32233236.
120. Chamberlain, SR, Fineberg, NA, Blackwell, AD, Robbins, TW, Sahakian, BJ. Motor inhibition and cognitive flexibility in obsessive-compulsive disorder and trichotillomania. Am J Psychiatry. 2006; 163(7): 12821284.
121. Chamberlain, SR, Fineberg, NA, Menzies, LA, et al. Impaired cognitive flexibility and motor inhibition in unaffected first-degree relatives of patients with obsessive-compulsive disorder. Am J Psychiatry. 2007; 164(2): 335338.
122. Rajender, G, Bhatia, MS, Kanwal, K, Malhotra, S, Singh, TB, Chaudhary, D. Study of neurocognitive endophenotypes in drug-naïve obsessive-compulsive disorder patients, their first-degree relatives and healthy controls. Acta Psychiatr Scand. 2011; 124(2): 152161.
123. Morein-Zamir, S, Fineberg, NA, Robbins, TW, Sahakian, BJ. Inhibition of thoughts and actions in obsessive-compulsive disorder: extending the endophenotype? Psychol Med. 2010; 40(2): 263272.
124. Braff, DL, Freedman, R. Endophenotypes in studies of the genetics of schizophrenia. In: Davis KL, Charney D, Coyle JT, Nemeroff C, eds. Neuropsychopharmacology: The Fifth Generation of Progress. Philadelphia: Lippincott, Williams & Wilkins; 2002; 103116.
125. Saperstein, AM, Fuller, RL, Avila, MT, et al. Spatial working memory as a cognitive endophenotype of schizophrenia: assessing risk for pathophysiological dysfunction. Schizophr Bull. 2006; 32(3): 498506.
126. Tumkaya, S, Karadag, F, Oguzhanoglu, NK. Neurological soft signs in schizophrenia and obsessive compulsive disorder spectrum. Eur Psychiatry. 2012; 27(3): 192199.
127. Souza, BR, Torres, KCL, Miranda, DM, et al. Lack of effects of typical and atypical antipsychotics in DARPP-32 and NCS-1 levels in PC12 cells overexpressing NCS-1. J Negat Results Biomed. 2010; 9: 4.
128. Gillman, PK. Tricyclic antidepressant pharmacology and therapeutic drug interactions updated. Br J Pharmacol. 2007; 151(6): 737748.
129. Feinberg, M. Clomipramine for obsessive-compulsive disorder. Am Fam Physician. 1991; 43(5): 17351738.
130. Skapinakis, P, Papatheodorou, T, Mavreas, V. Antipsychotic augmentation of serotonergic antidepressants in treatment-resistant obsessive-compulsive disorder: a meta-analysis of the randomized controlled trials. Eur Neuropsychopharmacol. 2007; 17(2): 7993.
131. Stein, DJ, Koen, N, NA, Fineberg, et al. A 2012 Evidence-based algorithm for the pharmacotherapy for obsessive-compulsive disorder. Curr Psychiatry Rep. 2012; 14(3): 211219.
132. Dold, M, Aigner, M, Lanzenberger, R, Kasper, S. Antipsychotic augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive-compulsive disorder: a meta-analysis of double-blind, randomized, placebo-controlled trials. Int J Neuropsychopharmacol. 2013; 16(3): 557574.
133. Jenike, MA, Baer, L, Minichiello, WE, Schwartz, CE, Carey, RJ Jr. Concomitant obsessive–compulsive disorder and schizotypal personality disorder. Am J Psychiatry. 1986; 143(4): 530532.
134. Dinn, WM, Aycicegi-Dinn, A, Göral, F, Yildirim, EA, Hacioglu, M. Treatment-resistant obsessive-compulsive disorder: clinical and personality correlates. Procedia Soc Behav Sci. 2014; 159: 239242.
135. Bogetto, F, Bellini, S, Vaschetto, P, Ziero, S. Olanzapine augmentation of fluvoxamine-refractory obsessive–compulsive disorder (OCD): a 12-week open trial. Psychiatry Res. 2000; 96(2): 9198.
136. Himle, JA, Van Etten, ML, Janeck, AS, Fischer, DJ. Insight as a predictor of treatment outcome in behavioral group treatment for obsessive–compulsive disorder. Cognitive Therapy and Research. 2006; 30(5): 661666.
137. Ravi Kishore, V, Samar, R, Janardhan Reddy, YC, Chandrasekhar, CR, Thennarasu, K. Clinical characteristics and treatment response in poor and good insight obsessive–compulsive disorder. Eur Psychiatry. 2004; 19(4): 202208.
138. Shetti, CN, Reddy, YC, Kandavel, T, et al. Clinical predictors of drug nonresponse in obsessive–compulsive disorder. J Clin Psychiatry. 2005; 66(12): 15171523.
139. Tolin, DF, Maltby, N, Diefenbach, GJ, Hannan, SE, Worhunsky, P. Cognitive–behavioral therapy for medication nonresponders with obsessive–compulsive disorder: a wait-list-controlled open trial. J Clin Psychiatry. 2004; 65(7): 922931.
140. Demet, MM, Deveci, A, Taşkin, EO, et al. Risk factors for delaying treatment seeking in obsessive–compulsive disorder. Compr Psychiatry. 2010; 51(5): 480485.
141. Eisen, JL, Rasmussen, SA, Phillips, KA, et al. Insight and treatment outcome in obsessive–compulsive disorder. Compr Psychiatry. 2001; 42(6): 494497.
142. Bandelow, B, Zohar, J, Hollander, E, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and post-traumatic stress disorders – first revision. World J Biol Psychiatry. 2008; 9(4): 248312.
143. Soomro, GM, Altman, D, Rajagopal, S, Oakley-Browne, M. Selective serotonin re-uptake inhibitors (SSRIs) versus placebo for obsessive compulsive disorder (OCD). Cochrane Database Syst Rev. 2008;(1): CD001765.
144. Stryjer, R, Dambinsky, Y, Timinsky, I, Green, T, Kotler, M, Weizman, A, Spivak, B. Escitalopram in the treatment of patients with schizophrenia and obsessive -compulsive disorder: an open-label, prospective study. J Clin Psychopharmacol. 2013; 28(2): 9698.
145. DeBattista, C, Sofuoglu, M, Schatzberg, AF. Serotonergic synergism: the risks and benefits of combining the selective serotonin reuptake inhibitors with other serotonergic drugs. Biol Psychiatry. 1998; 44(5): 341347.
146. Schirmbeck, F, Esslinger, C, Rausch, F, Englisch, S, Meyer-Lindenberg, A, Zink, M. Antiserotonergic antipsychotics are associated with obsessive-compulsive symptoms in schizophrenia. Psychol Med. 2011; 41(11): 23612373.
147. de Haan, L, Linszen, DH, Gorsira, R. Clozapine and obsessions in patients with recent-onset schizophrenia and other psychotic disorders. J Clin Psychiatry. 1999; 60(6): 364365.
148. Lykouras, L, Alevizos, B, Michalopoulou, P, Rabavilas, A. Obsessive–compulsive symptoms induced by atypical antipsychotics: a review of the reported cases. Prog Neuropsychopharmacol Biol Psychiatry. 2003; 27(3): 333346.
149. de Haan, L, Oekeneva, A, van, A T, Linszen, D. Obsessive-compulsive disorder and treatment with clozapine in 200 patients with recent-onset schizophrenia or related disorders. Eur Psychiatry. 2004; 19(8): 524.
150. Fonseka, TM, Richter, MA, Müller, DJ. Second generation antipsychotic-induced obsessive-compulsive symptoms in schizophrenia: a review of the experimental literature. Curr Psychiatry Rep. 2014; 16(11): 510.
151. Schirmbeck, F, Zink, M. Clozapine-induced obsessive-compulsive symptoms in schizophrenia: a critical review. Curr Neuropharmacol. 2012; 10(1): 8895.
152. Schirmbeck, F, Mier, D, Esslinger, C, et al. Increased orbitofrontal cortex activation associated with “pro-obsessive” antipsychotic treatment in patients with schizophrenia. J Psychiatry Neurosci. 2015; 40(2): 8999.
153. Juven-Wetzler, A, Fostick, L, Cwikel-Hamzany, S, Balaban, E, Zohar, J. Treatment with Ziprasidone for schizophrenia patients with OCD. Eur Neuropsychopharmacol. 2014; 24(9): 14541462.
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CNS Spectrums
  • ISSN: 1092-8529
  • EISSN: 2165-6509
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