Schizotypality and neurological soft signs in patients with obsessive– compulsive disorder

OBJECTIVES: The broad description of schizotypy includes cognitive, sensitive, and information processing deficits connected with thought disorder symptoms. Recently, the term of schizotypy has started to be researched, not only in schizophrenia patients and their relatives but also in other psychiatric populations. Neurological soft signs (NSS) are known as abnormal motor or sensorial findings in the absence of a localized neurological disorder. There are some studies referring to the association between obsessive–compulsive disorder (OCD) and NSS, and vice versa. In this study, we aimed to examine the differences between OCD patients and healthy control groups in terms of schizotypality and NSS. We also aimed to predict risk factors affecting OCD patients with schizotypal features.

METHODS: Overall, 92 OCD patients and 91 healthy controls were included in this study. Chapman’s Scales (Physical and Social Anhedonia Scales, Perceptual Aberration Scale, and Magical Ideation Scale) and Schizotypal Personality Questionnaire (SPQ) were administered to patient group. Symptom severity of OCD was recorded using the Yale-Brown Obsessive Compulsive Scale. The neurological portion of the Physical and Neurological Examination for Soft Signs (PANESS) and a Brief Psychiatric Rating Scale were administered to patient and control groups.

RESULTS: The patient group had higher scores on total PANESS scale (p < .001) and synergie (p = .012), graphestesia (p < .001), posture (p < .001), topognosia (p < .001), and repetitive movement (p < .001) subscales. There were no statistically significant differences in terms of stereognosis (p = .056) or continuity of movement (p = .79) subscales. We found that the sexual, religious, and order–symmetry obsessions and pathological doubt effects of schizotypality were independent risk factors for schizotypality in OCD.

CONCLUSIONS: Both the schizotypal features and NSS worsen the course of OCD and may point out the neurodevelopmental basis of the disease. We can say that OCD patients with high schizotypality should take a separate place on the schizo-obsessive spectrum.