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Schizo-obsessive spectrum disorders: an update

Published online by Cambridge University Press:  27 September 2016

Estêvão Scotti-Muzzi*
Affiliation:
Psychiatry Unit, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil
Osvaldo Luis Saide
Affiliation:
Psychiatry Unit, Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil
*
*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: [email protected])

Abstract

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.

Type
Review Articles
Copyright
© Cambridge University Press 2016 

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Footnotes

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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