The document discusses a proposed subtype of schizophrenia called "schizo-obsessive disorder" where patients have obsessions and compulsions unrelated to their psychosis. A study found that patients with schizo-obsessive disorder had longer hospitalizations, took more medications, and had poorer functioning than those with schizophrenia alone. They also exhibited more negative symptoms and poorer neuropsychological performance. The findings suggest schizo-obsessive patients may have a unique clinical profile within the schizophrenia spectrum. Treatment with serotonin reuptake inhibitors along with antipsychotics may effectively treat their obsessions and improve schizophrenia symptoms.

1. Schizo-obsessive disorder ? A new subtype of schizophrenia Dr J Romain Dr Yagoub

2. Possible definition Patients who have OCD and schizophrenia and whose obsessions and compulsions are unrelated to the content of their psychosis.

3. Controversy centres on whether there is a continuum or overlap in psychopathology between these entities that some authors have called "schizo-obsessive disorder."

4. Why do we care? Schizo-obsessive patients have a more chronic course, a greater frequency of social and occupational impairment, and show poor treatment response and a poor long-term outcome.

5. Research A study by Michael Y. Hwang, M.D in journal of neuropsychiatry and clinical neurosciences 12:91-94, Feb 2000 A pilot blind controlled study, 20pts Compared characteristics of obsessive-compulsive (OC) schizophrenic patients and a matched non-OC schizophrenic control group

6. Results- Schizo-obessive group Significantly longer periods of hospitalisation They took more adjunctive medications such as benzodiazepines and antidepressants They had a poorer clinical course with lower levels of functioning, especially in terms of "self-care" and "social competency”

7. Results for Schizo-obsessive group Higher rate of negative symptoms Higher level of general psychopathology using the Wisconsin Card Sorting Test (WCST) and MMSE. No difference in positive symptoms, anergia, depression or thought disturbance factors.

8. Summary of Study Findings indicate that schizo-obsessive patients may possess a unique clinical and neuropsychological profile within the schizophrenic spectrum

9. Possible treatment Regimes Treatment with serotonin reuptake blockers, added to a neuroleptic, is found to be efficacious in the treatment of obsessions and compulsions and to improve overall schizophrenic symptoms.

10. Discussion Both patients clearly exhibit hoarding as their obsessional symptom Hoarding is being considered as a part of OC spectrum in its own right for DSM-V Recent literature suggests that the core symptoms, associated features, and neurobiological abnormalities of hoarding differ from OCD.

11. Other Possible Diagnoses OC Schizophrenia? Compulsive hoarding syndrome with some psychotic symptoms?

12. Questions?