OCD and schizophrenia spectrum disorders often co-occur, making diagnosis and treatment complicated. Studies suggest that comorbidity may result in a less favorable treatment outcome, but more research is needed to fully understand the relationship between these diseases. OCD may be a predictor for schizophrenia, and there is a shared component that is not yet understood.
Obsessive-compulsive disorder or OCD and schizophrenia spectrum disorders are linked in several ways that are not fully understood. These conditions have a high incidence of co-occurring and can complicate a diagnosis when comorbid. There are several conclusions about how the presence of OCD and schizophrenia spectrum disorders together affects treatment. Some studies find that the conditions are easier to treat when they are together, and others suggest that comorbid presentation results in a less favorable treatment outcome. Mental health researchers have conducted limited studies on this topic over a considerable period of time, but the research only suggests that more studies are needed to understand the connections between these conditions and develop the best treatment protocols.
Studies of people with schizophrenia or any of the schizophrenia spectrum disorders show that a significant proportion of individuals with these conditions also have OCD. Percentages vary for each study, but a figure of around 20-25% is considered reasonable. The illnesses can occur together, some patients develop schizophrenia after they are diagnosed with OCD, or schizophrenia occurs first and OCD develops later.
Some researchers believe that OCD may be a predictor for schizophrenia and that OCD and conditions on the schizophrenia spectrum carry considerable risk of comorbidities. It must be said that obsessive-compulsive disorder is an anxiety disorder. There is an even greater risk for all anxiety disorders that precede schizophrenia or are present with any illness on the schizophrenia spectrum.
Doctors also mention the difficulty of diagnosing both diseases at the same time. Extreme obsessive or compulsive behavior can appear to be a symptom of schizophrenia spectrum disorders, and there are features of these disorders that resemble OCD. It can take some time to arrive at an accurate diagnosis if OCD and schizophrenia occur together. Especially when a patient has schizophrenia, the underlying OCD may go unrecognized and treatment for schizophrenia alone does not successfully address the obsessive-compulsive disorder. It is essential that psychiatrists consider covert OCD as a possible additional condition when diagnosing schizophrenia spectrum disorders.
The literature on the connection between OCD and schizophrenia is decidedly unclear on how treatment outcome is affected by comorbidity. When one of these diseases goes undiagnosed, treatment clearly suffers. Some research suggests that people with both conditions don’t fare equally well.
It can certainly be difficult to pursue any type of cognitive therapy that can address OCD issues, before freedom from overwhelmingly positive or negative schizophrenia symptoms is achieved. On the other hand, there are studies suggesting that OCD and schizophrenia spectrum disorders are easier to treat and predict a better outcome. These direct contradictions are part of the reason why larger and more definitive studies are needed.
Many researchers argue that the sum total of what is known about OCD and schizophrenia is still not enough to treat patients most effectively. The fact that these conditions occur together so often indicates that they may have a shared physiological, genetic, or other component that is not currently understood. More research appears to be needed to fully investigate the relationship between these diseases.
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