How is schizophrenia differentiated from obsessive-compulsive disorder (OCD)?

Updated: May 17, 2018
  • Author: William M Greenberg, MD; Chief Editor: David Bienenfeld, MD  more...
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The co-occurrence of schizophrenia and OCD is problematic for a variety of reasons. Not infrequently, individuals with schizophrenia do seem to have significant OC symptoms (sometimes, ironically, caused or exacerbated by the use of the very effective antipsychotic clozapine, whereas adjunctive antipsychotics may lessen treatment-resistant OC symptoms in those who do not have schizophrenia).

When OC symptoms are present in someone who has schizophrenia, they may meet criteria for a diagnosis of OCD, but such patients often respond poorly to the usual OCD treatments, and perhaps OCD in schizophrenia has a different pathophysiology.

Consider the following:

  • Family history of OCD, Tourette disorder, tics, ADHD, and other psychiatric diagnoses

  • Current or past substance abuse or dependence

  • Antecedent infections, especially streptococcal and herpetic infection

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