2004 issue 3


Volume 13, issue 3

Clinical observations

Obsessive-compulsive disorders and schizophrenia: differential diagnosis, co-morbidity, and management

1. II Oddziału Psychiatrycznego Szpitala Centrum Psychiatrii w Katowicach
Postępy Psychiatrii i Neurologii, 2004, 13 (3), 263-276
Keywords: obsession, compulsion, schizophrenia, differential diagnosis, co-morbidity


Objectives. An attempt was made in the paper to consider relationships between schizophrenia and obsessive-compulsive disorders in terms of possible dimensions (if any) to which these relationships might be reduced. At the same time the authors strived to assess the treatment methods proposed so far in cases of both these conditions concurrence.

Review. The authors draw attention to relatively frequent errors committed in differential diagnosis of severe anancastic disorders and schizophrenia, despite the fact that the two conditions are essentially different, from or even opposite to each other. Therefore, a comparison of their symptomatology is followed in the paper by an outline of differences in etiopathology and by a discussion of their mutual relationships. Having assumed that it is not possible to give a clear-cut definition of the possible role of obsessions in the course of schizophrenia, the authors propose that it is a complex, ambiguous process, individually specific and thus escaping standardization. The authors' main idea was to analyse the phenomenon of obsessive-compulsive disorders and schizophrenia co-morbidity from a wider perspective, as this would enable a more flexible approach to the diagnosis and treatment of individual patients.

Conclusions. The problems of OCD and schizophrenia co-morbidity are the source of considerable difficulty in the etiopathogenic, syndromological, and, above all, therapeutic dimensions. The lack of standards regarding parallel treatment of both these conditions is an incentive to further research in this area. It is definitely advisable to diagnose obsessions in the course of schizophrenia. This requires a closer co-operation with the patient, which in turn contributes not only to the search for more effective treatment methods, but also to the development of the patient's more trustful attitude and better mutual communication. All these factors may alleviate the patient's suffering, so considerable in schizophrenia associated with the OCD.

Address for correspondence:
Dr Maciej Żerdziński,
II Oddział Psychiatryczny Szpitala Centrum Psychiatrii,
ul. Korczaka 27,
40-340 Katowice