Obsessive-compulsive symptoms in schizophrenia patients and their first-degree relatives and the association with subclinical psychotic symptoms

Abstract

Objective

This study aimed to investigate the presence of obsessive-compulsive symptoms (OCS) in patients being followed for schizophrenia and their first-degree relatives (mother, father, siblings, and children) and the relationship between OCS and clinical/subclinical psychotic symptoms.

Materials and methods

The study included 110 schizophrenia patients followed up in a community mental health center and their first-degree relatives. Patients and relatives were evaluated using the SCID-I (Structured Clinical Interview Form for DSM-IV Axis-I Disorders) to ascertain their diagnosis and exclude other axis-I diagnoses. The Yale-Brown Obsessive Compulsive Scale was used to measure OCS severity. Psychotic symptom severity was evaluated in patients using the Positive and Negative Syndrome Scale (PANSS) and subthreshold psychotic symptoms and psychosis proneness were assessed in relatives using the Schizotypal Personality Questionnaire.

Results

The prevalence of clinically significant OCS was 41.8% in schizophrenia patients and 28.2% in their relatives. PANSS positive and general psychopathology subscale scores were higher in patients with OCS. Suspiciousness and interpersonal schizotypy scores were significantly higher in relatives with OCS compared to those without. The first-degree relatives of patients with OCS did not exhibit a higher prevalence of OCS or psychotic symptoms compared to the relatives of patients without OCS.

Conclusion

Our study demonstrates that obsessive-compulsive phenomena are common in schizophrenia patients and their relatives. Although there seems to be a positive association between OCS and psychotic symptoms in patients and their first-degree relatives, the intergenerational transmission of these two symptom groups may occur independently.

Keywords:

• Schizophrenia
• psychosis
• obsessive-compulsive symptoms
• schizo-obsessive
• comorbidity

Acknowledgements

The authors thank all the patients and their families for participating in the study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Barış Sancak

Barış Sancak, M.D., is a clinician, lecturer, and consultant at Acibadem University School of Medicine, Department of Psychiatry. He completed his psychiatry residency at Bakirkoy Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery. He worked at the Council of Forensic Medicine as a psychiatry specialist between 2018-2020. His research focuses on psychotic disorders, social psychiatry, consultation-liaison psychiatry, and criminality and mental health.

Güliz Özgen Hergül

Güliz Özgen Hergül, M.D., is a professor and head of the Giresun University Faculty of Medicine, Department of Psychiatry. She worked as the chief of a inpatient clinic at Bakirkoy Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery until 2018. Her research focuses on psychotic disorders, mood disorders, and forensic psychiatry.