Obsessive compulsive symptoms impair life quality in psychosis patients

By Mark Cowen

The presence of obsessive compulsive symptoms (OCS) is associated with reduced subjective wellbeing and quality of life (QoL) in patients with a first episode of psychosis, Dutch researchers report.

The team found a particularly strong relationship between OCS and poorer patient-reported social integration, emotional regulation, and mental and physical health.

"These results support the clinical relevance of OCS comorbidity in schizophrenia or related disorders and the need for research into specific interventions," comment Lieuwe de Haan and colleagues from the University of Amsterdam.

The researchers used the Structured Clinical Interview for DSM-III-revised patient edition to assess 198 patients with a first episode of schizophrenia, schizophreniform disorder, or schizoaffective disorder for the presence of comorbid OCS.

Patients with (n=23) and without (n=175) OCS were then compared using the Subjective Well-being under Neuroleptics (SWN) scale and the Manchester Short Assessment of Quality of Life (MANSA) scale.

The team found that patients with OCS had significantly lower mean SWN total scores and MANSA total scores than those without, at 68.8 versus 79.6 and 11.4 versus 14.7, respectively.

Regarding SWN subscales, patients with OCS had significantly lower scores than those without for social integration and emotional regulation, at 20.3 versus 23.6 and 14.0 versus 15.9, respectively. They also had nonsignificantly lower scores for all three other SWN subscales (self-control, mental functioning, and physical functioning).

Regarding MANSA subscales, patients with OCS had significantly lower scores for mental and physical health than those without, at 3.2 versus 4.1 and 2.1 versus 3.4, as well as nonsignificantly lower scores for the other two subscales (general and social life).

"We conclude that we have found evidence for a relationship between the presence of comorbid OCS and negative subjective experience and self-reported QoL," write de Haan et al in Early Intervention in Psychiatry.

They add: "Clinicians should be aware that the presence of even minor comorbid OCS may influence subjective well-being."

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