Obsessive-Compulsive Phenomena in Schizophrenia Spectrum Disorders
Summary
The co-occurrence of obsessive-compulsive phenomena and schizophrenia spectrum disorders represents a complex clinical constellation in which intrusive thoughts and repetitive behaviours exacerbate the burden of psychosis. Obsessive-compulsive symptoms (OCS) affect up to a third of individuals diagnosed with schizophrenia, often manifesting as checking compulsions, hoarding or intrusive ruminations that are phenomenologically distinct from delusions yet may be misinterpreted as psychotic phenomena. The emergence of OCS can precede, coincide with or follow the onset of psychosis and is influenced by antipsychotic treatment—particularly agents with strong antiserotonergic profiles. Patients with persistent OCS exhibit higher levels of anxiety, depression and functional impairment, and display poorer response to standard antipsychotic regimens. Increasing evidence suggests shared pathophysiological substrates, including dysregulation of serotonergic and dopaminergic circuits, as well as genetic overlap between schizophrenia and obsessive–compulsive disorder. A more precise characterisation of symptom clusters and underlying mechanisms has informed emerging therapeutic strategies, ranging from pharmacological augmentation to targeted cognitive–behavioural interventions, with the goal of reducing symptom severity and improving functional outcomes.
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Obsessive-Compulsive Phenomena in Schizophrenia Spectrum Disorders publication trend
The graph below shows the total number of articles in obsessive-compulsive phenomena in schizophrenia spectrum disorders across all publications each year (not limited to Nature Index journals).
Technical terms
Obsessive-compulsive symptoms (OCS): Recurrent intrusive thoughts (obsessions) and repetitive behaviours (compulsions) that cause marked distress and impairment.
Schizophrenia spectrum disorders: A range of conditions characterised by psychotic experiences, disordered thinking and social dysfunction, including schizophrenia and related syndromes.
Habit formation models: Theoretical frameworks describing how goal-directed behaviours transition into automatic responses through repeated reinforcement.
Genome-wide association studies (GWAS): Research approach that scans the entire genome to identify genetic variants associated with particular traits or disorders.
Mendelian randomisation: An analytical method using genetic variants as proxies to infer causality between risk factors and clinical outcomes in observational data.
References
- The role of psychosis and clozapine load in excessive checking in treatment-resistant schizophrenia: longitudinal observational study. The British Journal of Psychiatry (2024).
- Shared genetic loci and causal relations between schizophrenia and obsessive-compulsive disorder. Schizophrenia (2023).
- Disclosing common biological signatures and predicting new therapeutic targets in schizophrenia and obsessive–compulsive disorder by integrated bioinformatics analysis. BMC Psychiatry (2023).
- Comorbid obsessive-compulsive symptoms in schizophrenia: contributions of pharmacological and genetic factors. Frontiers in Pharmacology (2013).
- Prevalence of obsessive compulsive symptoms among patients with schizophrenia. Industrial Psychiatry Journal (2009).
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