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Obsessive-compulsive disorder in UK clozapine-treated schizophrenia and schizoaffective disorder: a cause for clinical concern

¹ National Obsessive Compulsive Disorders Treatment Service, Department of Psychiatry, Queen Elizabeth II Hospital, Herts. Partnership NHS Foundation Trust, Welwyn Garden City, Hertfordshire, UK
² University of Hertfordshire, College Lane, Hatfield, UK
³ National Obsessive Compulsive Disorders Treatment Service, Department of Psychiatry, Queen Elizabeth II Hospital, Herts. Partnership NHS Foundation Trust, Welwyn Garden City, Hertfordshire, UK; University of Hertfordshire, College Lane, Hatfield, UK

^* To whom correspondence should be addressed.

	Abstract

Abstract

The association between schizophrenia and obsessive-compulsive disorder (OCD) is complex. This study systematically examined a UK cohort of clozapine-treated individuals with schizophrenia/schizoaffective disorder. Fourteen of 59 cases (24%) scored positively on item H of the Mini-International Neuropsychiatric Interview (MINI) for OCD. The mean Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) score in MINI-positive cases was 17.6 (SD ± 6.3). Sixty-four percent scored 16 or more on the Y-BOCS, representing clinically meaningful illness severity. Seven (50%) patients with OCD had previously received the diagnosis by their treating clinicians and were already receiving with selective serotonin re-uptake inhibitors (SSRIs) treatment. OCD cases scored significantly worse than their non-OCD counterparts on the Abnormal Involuntary Movement Scale (P = 0.01) and the Simpson Angus Scale (SAS; P  ratings for OCD cases on the Clinical Global Impression-Schizophrenia scale (P n  not on SSRI (n  (P  clozapine for schizophrenic disorders and that the comorbidity is associated with greater motoric impairment. The role of medication in this condition remains unclear.

Key Words: clozapine, OCD, schizophrenia

First published on May 30, 2008, doi:10.1177/0269881108089582

Journal of Psychopharmacology 2009;23:6.

A more recent version of this article appeared on January 1, 2009


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