Research evidence attests to the parallel similarities and the reciprocal nature of obsessive-compulsive disorder (OCD) and schizophrenia (SCZ) in such a manner that OCD and SCZ may progress into one another. We explore this evidence by presenting a theoretical and empirical phenomenological perspective to account for and elucidate the shared psychopathology of thought, perception, and motor impairment between these disorders. The purpose of this paper is to communicate that OCD and SCZ, while preserving their individuality, share related accounts of their phenomenology within a temporal and spatial frame of reference.

Functional brain-imaging studies have suggested an opposite pattern of brain activity in obsessive-compulsive disorder (OCD) and schizophrenia. Patients with OCD have higher than normal activity in the frontal lobe and caudate nucleus while patients with schizophrenia have lower than normal activity in these areas. Changes in the nature of the connections between the executive and impulse control regions of the frontal lobe and the basal ganglia might be involved in both illnesses. These findings are statistical in nature and involve structures of complex three-dimensional shapes. New technology for studying the function of these structures may be useful in exploring the relation of each structure to symptoms of specific disorders. This technology may also enable identification of anatomical and functional causes of individual differences in medication response.

While obsessive-compulsive (OC) symptoms in schizophrenia have been reported for many years, they have achieved only limited recognition and, perhaps for this reason, few studies their pharmacological treatment have been carried out. One suggested treatment approach is the use of different agents for different symptoms. In this article, we review the small number of published studies and case reports regarding this multi-pharmacological method of treatment for OC symptoms in schizophrenia. While each study used a somewhat different patient population and provided varying and limited information concerning patient sample, study design, and results, some tentative conclusions and treatment recommendations may be drawn from their findings.

The authors retrospectively reviewed the charts of all patients seen by the Psychiatric Consultation Service at their institution between January 1, 1989 to December 31, 1992. A total of 94 patients were evaluated for competency (study group). These were compared with 88 diagnostically matched patients (control group) who were assessed for reasons other than competency during the same time period. Patients in the study group were more likely to be black, less likely to be prescribed psychotropics, and more likely to be consulted upon later on during the course of their hospitalization. Among patients assessed for competency (study group) those patients judged to be incompetent were more likely to be older, have organic mental disorders (OMD), be prescribed psychotropics, and have longer hospital stays. Amongst patients in the study group, geriatric patients (> 60) when compared with nongeriatric patients were more likely to be female, Caucasian, and have OMD and multiple medical illnesses.