Obsessive‐compulsive disorder plus schizotypal personality disorder: Is the sum more than the parts?

Different studies have identified specific clinical characteristics of patients with obsessive-compulsive disorder (OCD) in comorbidity with schizotypal personality disorder (SPD), although no perspective evaluations of prognosis and response to treatment have been conducted so far. The aims of the present study were to evaluate: (1) the clinical and demographic correlates of OCD patients with comorbid SPD (OCD-SPD) using standardized instruments; (2) the response of OCD-SPD patients to long-term naturalistic pharmacological treatment. Socio-demographic and clinical characteristics of patients with OCD-SPD were compared to patients with “pure OCD”. OCD-SPD patients were characterized by a greater severity of obsessive-compulsive symptomatology, earlier age at onset, a higher rate of schizophrenia spectrum disorders in their first-degree relatives and a poorer insight. During the observational period, OCD-SPD patients were less likely to achieve remission of their symptomatology and required a greater number of trials with different antipsychotic drugs or received more frequently augmentation with antipsychotics. Our findings suggested that comorbidity with SPD is correlated to a poor treatment response in OCD patients and a reduced likelihood to recover from OCD symptoms, following standard pharmacological treatments. Further research is needed to identify alternative strategies for the management of this cohort of patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text

Successful treatment of obsessive — compulsive disorder with concurrent schizotypal personality disorder

European Neuropsychopharmacology ◽

10.1016/s0924-977x(98)90088-8 ◽

1998 ◽

Vol 8 ◽

pp. S28

Keyword(s):

Personality Disorder ◽

Obsessive Compulsive Disorder ◽

Successful Treatment ◽

Schizotypal Personality Disorder ◽

Obsessive Compulsive ◽

Schizotypal Personality ◽

Compulsive Disorder

Download Full-text

Schizotypal personality disorder in clinical obsessive–compulsive disorder samples: a brief overview

CNS Spectrums ◽

10.1017/s1092852920001716 ◽

2020 ◽

pp. 1-13

Author(s):

Luigi Attademo ◽

Francesco Bernardini

Keyword(s):

Personality Disorder ◽

Obsessive Compulsive Disorder ◽

Schizotypal Personality Disorder ◽

Obsessive Compulsive ◽

Schizotypal Personality ◽

Compulsive Disorder ◽

Schizophrenia Spectrum ◽

Categorical Diagnosis ◽

Psychotic Features ◽

The Relationship

Abstract Obsessive–compulsive disorder (OCD) is a chronic and disabling mental disorder characterized by the presence of obsessions and/or compulsions that cause major distress and impair important areas of functioning. About 9 out of 10 patients with OCD have comorbid psychiatric diagnoses. A high proportion of clinically diagnosed OCD patients fulfill diagnostic criteria of a schizophrenia spectrum disorder, to the point that significant evidence in the literature supports the existence and the clinical relevance of a schizo-obsessive spectrum of disorders, including schizotypal personality disorder (SPD) with OCD (schizotypal OCD). In this paper, we provide a brief but comprehensive analysis of the literature on the clinical coexistence between OCD and SPD. The clinical validity of the so-called schizotypal OCD is analyzed through a comprehensive investigation of the relationship between SPD features and obsessive–compulsive phenomena in clinical OCD samples. This review describes the potential connections between OCD and SPD on the epidemiological, sociodemographic, psychopathological, and clinical levels. SPD is commonly observed in OCD patients: about 10% of OCD patients have a full categorical diagnosis of SPD. Early clinical identification of SPD features—and, more generally, of psychotic features and personality disorders—in OCD patients is strongly recommended. In fact, a proper and early diagnosis with early treatment may have benefits for prognosis. However, although schizotypal OCD seems to have clinical and predictive validity, further neurobiological and genetic studies on etiological specificity are warranted.

Download Full-text