Obsessive-Compulsive Disorder Comorbidity in Children with Schizophrenia: Treatment Response and Clinical Course

Objective: Obsessive-compulsive disorder (OCD) is notably co-morbid in patients with schizophrenia. This overlap has drawn attention since several decades and the validity of a unique disorder recently named “Schizo-Obsessive Disorder (SOD)” has been queried by researchers. This study aimed to evaluate the treatment response and clinical course of children with both schizophrenia and OCD.

Methods: Ten children with both schizophrenia comorbid with OCD diagnoses and 19 children having pure schizophrenia were enrolled. All subjects were drawn from the database of Psychotic and Affective Disorders Outpatient Clinics of Ege University’s Child and Adolescent Psychiatry Department. The mean drug doses at the points of remission and first psychotic episodes were standardized by using chlorpromazine equivalent dosages. The severity and clinical features of the illness were measured by CGI, YBOCS, and PANSS.

Results: The mean drug doses for first psychotic episodes were 491±376 mg in SOD group and 290±209 mg in pure schizophrenia group (p=0.018). This significance was also found for the mean doses for remission (512.40±336.22 in SOD and 296.05±147.25, p=0.012). We found no statistical differenceS in the scores of CGI (SOD vs. pure schizophrenia: 5±0.66 vs. 4.36±0.83, p=0.094), and PANSS (67.60±11.84 vs. 69.84±14.62, p=0.573). YBOCS total score was 18.40 ±6.99 in SOD children. We did not find any significant correlations between YBOCS, PANSS, CGI scores, and the mean drug doses at assessment points.

Conclusions: Children with both schizophrenia and OCD may require greater antipsychotic dosage than traditional schizophrenia cases to achieve the same clinical response. The clinical features of ‘schizo-obsessive’ children are similar to their adult counterparts.