COMORBIDITY OF OBSESSIVE-COMPULSIVE AND PSYCHOTIC SYMPTOMS - A REVIEW

Go-occurrence of psychotic and obsessive-compulsive symptoms was first reported nearly 70 years ago. This paper reviews published reports fr om two perspectives: psychotic disorders with obsessive-compulsive sym ptoms and obsessive-compulsive disorder (OCD) with psychotic symptoms. Older investigations reported a low rate of comorbidity between these two disorders, but more-recent studies, in which systematic diagnosti c criteria have been used, have suggested that the rate of co-occurren ce of symptoms is higher than was previously thought. The difficulty i n diagnosing patients with obsessive-compulsive and psychotic symptoms is reviewed, and the importance of this distinction for treatment and prognosis is discussed. Although the comorbid diagnosis of schizophre nia and OCD, or of OCD and psychotic features, seems to portend a wors e prognosis than for either illness alone, the available data suggest that some patients with schizophrenia and OC symptoms may improve with traditional antiobsessional treatment.