Comorbid obsessive-compulsive symptoms (OCSs) and obsessive-compulsive disorder (OCD) in patients with schizophrenia treated with clozapine or haloperidol

Abstract

Aims: A case-control study is done aiming(i)to explore the prevalence of OCSs and OCD among patients with Schizophrenia treated with Clozapine(Target group)in comparison with those treated with Haloperidol(Control group), (ii) to identify the associative factors in relationship with OCSs and OCD in Schizophrenia patients treated with Clozapine in comparison with Haloperidol , (iii)to find out predictors for the increase of OCSs and OCD among patients treated with Clozapine in comparison with Haloperidol. All these information may contribute to the understanding of the underlying etiology of OCSs and OCD.

Method: Sample is comprised with patients aged 18-65 who meet the diagnostic criteria of Schizophrenia-spectrum disorder based on ICD 10 and retrieval of medical records. A total of 120 patients, comprising 30 males and 30 females patients currently prescribed with Clozapine(Target group)whereas30 male and 30 female patients are currently prescribed with Haloperidol (Control group)were identified from the Schizophrenia outpatient clinic in the same hospital. Both groups will be matched with gender. Obsessive compulsive symptoms were measured with the Chinese version of Yale-Brown Obsessive-Compulsive Scale to rate the severity of the symptoms. The severity of Schizophrenia symptoms was rated by the Positive and Negative Syndrome Scale, and the Clinical Global Impression was used to measure severity symptoms in general. The social functioning of patient was rated by The Social and Occupational Functioning Assessment Scale(SOFAS). A clinical interview questionnaire was developed to determine the social and demographic characteristics, as well as other clinical features of the disorder. It included patient’s age, frequency of hospitalisation, age of onset and duration of Schizophrenia, age of onset and duration of OCSs and OCD and age of first hospitalisation, Duration of Untreated Psychosis (DUP) and current antipsychotic medication dosage( Chlorpromazine equivalent dose).

Results: From the 120 patients identified and approached, 96 (80%) patients (48 male and 48 female patients) were consented for the study. The current study found that among those prescribed with Clozapine (Target group), there were 26.5% comorbid with OCSs and OCD, whereas none patients reported OCSs and OCD among the Haloperidol Control group.

Patients with OCSs and OCD were significantly correlated with PANSS Positive Syndrome Score and PANSS Total Syndrome Score factors analysis by the N Par test of Mann-Whitney U, Wilcoxon W and Z score for Asymp.

Using correlations test analysis, the most significantly factors to OCSs and OCD are Clozapine (Target group), PANSS Positive Syndrome Score and PANSS Total Syndrome Score.

Result showed that those three factors cannot be the prediction of OCSs and OCD from the Binary logistic regression analysis.