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European Archives of Psychiatry and Clinical Neuroscience

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Open Access 01-04-2018 | Original Paper

Obsessive–compulsive symptoms and overall psychopathology in psychotic disorders: longitudinal assessment of patients and siblings

Authors: Frederike Schirmbeck, Marije Swets, Carin J. Meijer, Mathias Zink, Lieuwe de Haan, GROUP investigators

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 3/2018

Abstract

The course of obsessive–compulsive symptoms (OCS) and its association with alterations in other clinical variables in patients with psychotic disorders is insufficiently known. Patients (n = 602) and unaffected siblings (n = 652) from the Dutch Genetic Risk and Outcome of Psychosis (GROUP) study were investigated at baseline and after 3 years. Participants were assigned to four groups based on the course of OCS over time: no-OCS, persistent OCS, initial OCS and de novo OCS. In addition to cross-sectional comparisons, longitudinal associations between changes in OCS and symptoms of schizophrenia and general functioning were investigated. Patients with co-occurring OCS reported significantly higher severity of psychotic and affective symptoms as well as lower overall functioning compared to patients without OCS. These differences were stable over time for patients reporting persistent OCS. Subsequent repeated measure analysis revealed significant interaction effects for groups reporting changes in their OCS. Whereas the group with remission of initial OCS showed significant improvement in positive symptoms, emotional distress and functioning, the de novo group showed no significant change in these variables, but rather reported stable higher psychopathology. Similar results were found on a subclinical level in siblings. Patients with co-occurring OCS present a more severe clinical picture, especially if symptoms persist over time. The remission of OCS was associated with overall improvement, whereas individuals with de novo OCS already reported higher clinical impairment before OCS onset. More research is needed to elucidate causal pathways and to develop effective interventions for persistent comorbid OCS.

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Swets M, Dekker J, van Emmerik-van Oortmerssen K, Smid GE, Smit F, de Haan L, Schoevers RA (2014) The obsessive compulsive spectrum in schizophrenia, a meta-analysis and meta-regression exploring prevalence rates. Schizophr Res 152(2–3):458–468CrossRefPubMed

Achim AM, Maziade M, Raymond E, Olivier D, Merette C, Roy MA (2011) How prevalent are anxiety disorders in schizophrenia? A meta-analysis and critical review on a significant association. Schizophr Bull 37(4):811–821CrossRefPubMed

Buckley P, Hwang M (2015) Comorbid psychiatric disorders in schizophrenia: more than just a chance co-occurrence. In: De Haan L, Schirmbeck F, Zink M (eds) Obsessive–compulsive symptoms in schizophrenia. Springer, Berlin, pp 3–10

Cederlof M, Lichtenstein P, Larsson H, Boman M, Ruck C, Landen M, Mataix-Cols D (2015) Obsessive–compulsive disorder, psychosis, and bipolarity: a longitudinal cohort and multigenerational family study. Schizophr Bull 41(5):1076–1083CrossRefPubMed

Dowling FG, Pato MT, Pato CN (1995) Comorbidity of obsessive–compulsive and psychotic symptoms: a review. Harv Rev Psychiatry 3(2):75–83CrossRefPubMed

Stengel E (1945) A study on some clinical aspects of the relationship between obsessional neurosis and psychotic reaction types. J Ment Sci 91:166–187CrossRef

Lysaker PH, Whitney KA, Davis LW (2006) Obsessive–compulsive and negative symptoms in schizophrenia: associations with coping preference and hope. Psychiatry Res 141(3):253–259CrossRefPubMed

de Haan L, Sterk B, van der Valk R (2013) 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 7(3):285–290CrossRefPubMed

Fenton WS, McGlashan TH (1986) The prognostic significance of obsessive–compulsive symptoms in schizophrenia. Am J Psychiatry 143(4):437–441CrossRefPubMed

10.

de Haan L, Sterk B, Wouters L, Linszen DH (2012) The 5-year course of obsessive–compulsive symptoms and obsessive–compulsive disorder in first-episode schizophrenia and related disorders. Schizophr Bull 39(1):151–160CrossRef

11.

Schirmbeck F, Rausch F, Englisch S, Eifler S, Esslinger C, Meyer-Lindenberg A, Zink M (2012) Stable cognitive deficits in schizophrenia patients with comorbid obsessive–compulsive symptoms: a 12 months longitudinal study. Schizophr Bull 39(6):1261–1271CrossRefPubMedPubMedCentral

12.

Varlakova Y, Patel D, Mukhopadhaya K, Laws K, David E, Sukwinder K, Fineberg N (2015) The neurocognitive and behavioural impact of comorbid obsessive–compulsive syndrome in schizophrenia. In: De Haan L, Schirmbeck F, Zink M (eds) Obsessive–compulsive symptoms in schizophrenia. Springer, Berlin, pp 91–114

13.

Hwang MY, Kim SW, Yum SY, Opler LA (2009) Management of schizophrenia with obsessive–compulsive features. Psychiatr Clin North Am 32(4):835–851CrossRefPubMed

14.

Cunill R, Castells X, Simeon D (2009) Relationships between obsessive–compulsive symptomatology and severity of psychosis in schizophrenia: a systematic review and meta-analysis. J Clin Psychiatry 70(1):70–82CrossRefPubMed

15.

Lysaker PH, Lancaster RS, Nees MA, Davis LW (2004) Patterns of obsessive–compulsive symptoms and social function in schizophrenia. Psychiatry Res 125(2):139–146CrossRefPubMed

16.

Öngür D, Goff DC (2005) Obsessive–compulsive symptoms in schizophrenia: associated clinical features, cognitive function and medication status. Schizophr Res 75:349–362CrossRefPubMed

17.

Guillem F, Satterthwaite J, Pampoulova T, Stip E (2009) Relationship between psychotic and obsessive compulsive symptoms in schizophrenia. Schizophr Res 115(2–3):358–362CrossRefPubMed

18.

Hunter H, Lysaker P (2015) Associations of comorbid obsessive–compulsive symptoms with psychotic and affective symptoms and general functioning. In: De Haan L, Schirmbeck F, Zink M (eds) Obsessive–compulsive symptoms in schizophrenia. Springer, Berlin, pp 77–88

19.

Nasrollahi N, Bigdelli I, Mohammadi MR, Hosseini SM (2012) The relationship between obsessions and compulsions and negative and positive symptoms in schizophrenia. Iran J Psychiatry 7(3):140–145PubMedPubMedCentral

20.

Poyurovsky M, Faragian S, Shabeta A, Kosov A (2008) Comparison of clinical characteristics, co-morbidity and pharmacotherapy in adolescent schizophrenia patients with and without obsessive–compulsive disorder. Psychiatry Res 159(1–2):133–139CrossRefPubMed

21.

Faragian S, Pashinian A, Fuchs C, Poyurovsky M (2009) Obsessive–compulsive symptom dimensions in schizophrenia patients with comorbid obsessive–compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 33(6):1009–1012CrossRefPubMed

22.

Tibbo P, Kroetsch M, Chue P, Warneke L (2000) Obsessive–compulsive disorder in schizophrenia. J Psychiatr Res 34(2):139–146CrossRefPubMed

23.

Poyurovsky M, Fuchs C, Weizman A (1999) Obsessive–compulsive disorder in patients with first-episode schizophrenia. Am J Psychiatry 156(12):1998–2000PubMed

24.

de Haan L, Hoogenboom B, Beuk N, van Amelsvoort T, Linszen D (2005) Obsessive–compulsive symptoms and positive, negative, and depressive symptoms in patients with recent-onset schizophrenic disorders. Can J Psychiatry 50(9):519–524CrossRefPubMed

25.

Bottas A, Cooke RG, Richter MA (2005) Comorbidity and pathophysiology of obsessive–compulsive disorder in schizophrenia: is there evidence for a schizo-obsessive subtype of schizophrenia? J Psychiatry Neurosci 30(3):187–193PubMedPubMedCentral

26.

Lysaker PH, Whitney KA (2009) Obsessive–compulsive symptoms in schizophrenia: prevalence, correlates and treatment. Expert Rev Neurother 9(1):99–107CrossRefPubMed

27.

Kim SW, Jeong BO, Kim JM, Shin IS, Hwang MY, Amminger GP, Nelson B, Berk M, McGorry P, Yoon JS (2015) Associations of obsessive–compulsive symptoms with clinical and neurocognitive features in schizophrenia according to stage of illness. Psychiatry Res 226(1):368–375CrossRefPubMed

28.

Fontenelle LF, Lin A, Pantelis C, Wood SJ, Nelson B, Yung AR (2011) A longitudinal study of obsessive–compulsive disorder in individuals at ultra-high risk for psychosis. J Psychiatr Res 45(9):1140–1145CrossRefPubMed

29.

Korver N, Quee PJ, Boos HBM, Simons CJP, de Haan L, GROUP I (2012) Genetic Risk and Outcome of Psychosis (GROUP), a multi site longitudinal cohort study focused on gene-environment interaction: objectives, sample characteristics, recruitment and assessment methods. Int J Methods Psychiatr Res 21(3):205–221CrossRefPubMed

30.

American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn. Washington, DC.

31.

Andreasen NCFM (1992) The comprehensive assessment of symptoms and history (cash): an instrument for assessing diagnosis and psychopathology. Arch Gen Psychiatry 49(8):615–623CrossRefPubMed

32.

Wing JKBT, Brugha TT et al (1990) Scan: schedules fonr clinical assessment in neuropsychiatry. Arch Gen Psychiatry 47(6):589–593CrossRefPubMed

33.

Organisation WH (1992) The Composite International Diagnostic Interview (CIDI). Authorized core version 1.0. World Health Organisation, Geneva

34.

Goodman WK, Price LH, Rasmussen SA, Mazure C (1989) The Yale-Brown Obsessive Compulsive Scale: I. Development, use, and reliability. Arch Gen Psychiatry 46(11):1006–1011CrossRefPubMed

35.

de Haan L, Hoogeboom B, Beuk N, Wouters L, Dingemans PM, Linszen DH (2006) Reliability and validity of the Yale-Brown Obsessive–Compulsive Scale in schizophrenia patients. Psychopharmacol Bull 39(1):25–30PubMed

36.

Boyette L, Swets M, Meijer C, Wouters L, Authors GROUP (2011) Factor structure of the Yale-Brown Obsessive–Compulsive Scale (Y-BOCS) in a large sample of patients with schizophrenia or related disorders and comorbid obsessive–compulsive symptoms. Psychiatry Res 186(2–3):409–413CrossRefPubMed

37.

Kay SR, Fiszbein A, Opler LA (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 13:261–276CrossRefPubMed

38.

van der Gaag M, Hoffman T, Remijsen M, Hijman R, de Haan L, van Meijel B, van Harten PN, Valmaggia L, de Hert M, Cuijpers A, Wiersma D (2006) The five-factor model of the Positive and Negative Syndrome Scale II: a ten-fold cross-validation of a revised model. Schizophr Res 85(1–3):280–287PubMed

39.

Stefanis NC, Hanssen M, Smirnis NK, Avramopoulos DA, Evdokimidis IK, Stefanis CN, Verdoux H, van Os J (2002) Evidence that three dimensions of psychosis have a distribution in the general population. Psychol Med 32(2):347–358CrossRefPubMed

40.

Jones SH, Thornicroft G, Coffey M, Dunn G (1995) A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF). Br J Psychiatry 166(5):654–659CrossRefPubMed

41.

Pedersen G, Karterud S (2012) The symptom and function dimensions of the Global Assessment of Functioning (GAF) scale. Compr Psychiatry 53(3):292–298CrossRefPubMed

42.

Bosanac P, Mancuso SG, Castle DJ (2016) Anxiety symptoms in psychotic disorders: results from the Second Australian National Mental Health Survey. Clin Schizophr Relat Psychoses 10(2):93–100CrossRefPubMed

43.

Murphy DL, Timpano KR, Wheaton MG, Greenberg BD, Miguel EC (2010) Obsessive–compulsive disorder and its related disorders: a reappraisal of obsessive–compulsive spectrum concepts. Dialogues Clin Neurosci 12(2):131–148PubMedPubMedCentral

44.

Rickelt J, Viechtbauer W, Lieverse R, Overbeek T, van Balkom AJ, van Oppen P, van den Heuvel OA, Marcelis M, Eikelenboom M, Tibi L, Schruers KR (2016) The relation between depressive and obsessive–compulsive symptoms in obsessive–compulsive disorder: results from a large, naturalistic follow-up study. J Affect Disord 203:241–247

45.

Schirmbeck F, Zink M (2013) Cognitive behavioural therapy for obsessive–compulsive symptoms in schizophrenia. Cogn Behav Therapist 6(7):1–13

46.

de Haan L, Zink M (2015) Clinical presentation of obsessive–compulsive symptoms in patients with psychotic disorders psychopathological concepts, differential diagnosis, and symptom presentation. In: De Haan L, Schirmbeck F, Zink M (eds) Obsessive–compulsive symptoms in schizophrenia. Springer, Berlin, pp 33–45

47.

Schirmbeck F, Swets M, de Haan L (2015) Epidemiology: prevalence and clinical characteristics of obsessive–compulsive disorder and obsessive–compulsive symptoms in patients with psychotic disorders. In: De Haan L, Schirmbeck F, Zink M (eds) Obsessive–compulsive symptoms in schizophrenia. Springer, Berlin, pp 47–61

48.

Poyurovsky M, Kriss V, Weisman G, Faragian S, Schneidman M, Fuchs C, Weizman A, Weizman R (2005) Familial aggregation of schizophrenia-spectrum disorders and obsessive–compulsive associated disorders in schizophrenia probands with and without OCD. Am J Med Genet Part B Neuropsychiatr Genet 133B(1):31–36CrossRef

49.

Rao NP, Venkatasubramanian G (2015) Obsessive–compulsive symptoms in schizophrenia: neurophysiological and neuroimaging findings. In: De Haan L, Schirmbeck F, Zink M (eds) Obsessive–compulsive symptoms in schizophrenia. Springer, Cham, pp 135–146

50.

Scotti-Muzzi E, Saide OL (2016) Schizo-obsessive spectrum disorders: an update. CNS Spectr 27:1–15

51.

Saxena S, Brody AL, Schwartz JM, Baxter LR (1998) Neuroimaging and frontal-subcortical circuitry in obsessive–compulsive disorder. Br J Psychiatry 173(35S):26–37

52.

Weinberger DR, Egan MF, Bertolino A, Callicott JH, Mattay VS, Lipska BK, Berman KF, Goldberg TE (2001) Prefrontal neurons and the genetics of schizophrenia. Biol Psychiatry 50(11):825–844CrossRefPubMed

53.

Cavallaro R, Cavedini P, Mistretta P, Bassi T, Angelone SM, Ubbiali A, Bellodi L (2003) Basal-corticofrontal circuits in schizophrenia and obsessive–compulsive disorder: a controlled, double dissociation study. Biol Psychiatry 54(4):437–443CrossRefPubMed

54.

Lysaker PH, Marks KA, Picone JB, Rollins AL, Fastenau PS, Bond GR (2000) Obsessive and compulsive symptoms in schizophrenia: clinical and neurocognitive correlates. J Nerv Ment Dis 188(2):78–83CrossRefPubMed

55.

Robinson LJ, Freeston MH (2014) Emotion and internal experience in obsessive compulsive disorder: reviewing the role of alexithymia, anxiety sensitivity and distress tolerance. Clin Psychol Rev 34(3):256–271CrossRefPubMed

56.

Cougle JR, Timpano KR, Sarawgi S, Smith CM, Fitch KE (2013) A multi-modal investigation of the roles of distress tolerance and emotional reactivity in obsessive–compulsive symptoms. Anxiety Stress Coping 26(5):478–492CrossRefPubMed

57.

Myin-Germeys I, van Os J, Schwartz JE, Stone AA, Delespaul PA (2001) Emotional reactivity to daily life stress in psychosis. Arch Gen Psychiatry 58(12):1137–1144CrossRefPubMed

58.

Nugent KL, Chiappelli J, Rowland LM, Daughters SB, Hong LE (2014) Distress intolerance and clinical functioning in persons with schizophrenia. Psychiatry Res 220(1–2):31–36CrossRefPubMedPubMedCentral

59.

Schirmbeck F, Boyette L-L, Rvd Valk, Meijer C, Dingemans P, Van R, de Haan L, Kahn RS, de Haan L, van Os J, Wiersma D, Bruggeman R, Cahn W, Meijer C, Myin-Germeys I (2015) Relevance of five-factor model personality traits for obsessive–compulsive symptoms in patients with psychotic disorders and their un-affected siblings. Psychiatry Res 225(3):464–470CrossRefPubMed

60.

Schirmbeck F, Esslinger C, Rausch F, Englisch S, Meyer-Lindenberg A, Zink M (2011) Antiserotonergic antipsychotics are associated with obsessive–compulsive symptoms in schizophrenia. Psychol Med 41(11):2361–2374CrossRefPubMed

61.

Schirmbeck F, Zink M (2015) Effects of antipsychotic treatment on obsessive–compulsive symptoms. In: De Haan L, Schirmbeck F, Zink M (eds) Obsessive–compulsive symptoms in schizophrenia. Springer, Berlin, pp 147–175

Title: Obsessive–compulsive symptoms and overall psychopathology in psychotic disorders: longitudinal assessment of patients and siblings
Authors: Frederike Schirmbeck
Marije Swets
Carin J. Meijer
Mathias Zink
Lieuwe de Haan
GROUP investigators
Publication date: 01-04-2018
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Psychiatry and Clinical Neuroscience / Issue 3/2018
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI: https://doi.org/10.1007/s00406-016-0751-0

At a glance: The STEP trials

Springer Medicine

Obsessive–compulsive symptoms and overall psychopathology in psychotic disorders: longitudinal assessment of patients and siblings

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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