Obsessive compulsive symptoms in the psychosis prodrome: Correlates of clinical and functional outcome

Niendam, Tara A.; Berzak, Jodi; Cannon, Tyrone D.; Bearden, Carrie E.

doi:10.1016/j.schres.2008.11.023

« Previous Next »Schizophrenia Research
Volume 108, Issue 1 , Pages 170-175, March 2009

Obsessive compulsive symptoms in the psychosis prodrome: Correlates of clinical and functional outcome

Tara A. Niendam
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, United States
- Corresponding author. UC Davis Imaging Research Center 4701 X Street, Sacramento, CA 95817, United States Tel.: +916 734 4528; fax: +916 734 8750.
Jodi Berzak
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, United States
Tyrone D. Cannon
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Box 956968, Suite 2265, 300 Medical Plaza, Los Angeles, CA 90095-6968, United States
Carrie E. Bearden
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Box 956968, Suite 2265, 300 Medical Plaza, Los Angeles, CA 90095-6968, United States

Received 1 August 2008; received in revised form 17 November 2008; accepted 19 November 2008. published online 22 December 2008.

Abstract

Objectives:

Obsessive–Compulsive Disorder (OCD) is a common co-morbid condition in schizophrenia, associated with poor prognosis. However, the prevalence of obsessive compulsive symptomatology (OCS) and its relationship to outcome has not been evaluated in adolescents at ultra high-risk for psychosis (UHR).

Methods:

Sixty-four UHR and 26 non-prodromal comparison (NPC) youth were ascertained using the Structured Interview for Prodromal Syndromes (SIPS). Participants completed diagnostic interviews and the Padua Inventory (Sanavio, E., 1988. Obsessions and compulsions: the Padua Inventory. Behav. Res. Ther. 26, 169–177.), a self-report measure of OCS.

Results:

UHR youth reported significantly higher rates of OCS on the Padua Inventory compared to NPC youth. Clinical diagnosis of OCD (20% of sample) was associated with lower risk of conversion to psychosis over the follow-up period, but was unrelated to clinical severity or psychosocial functioning. However, dimensional ratings of OCS were significantly associated with positive symptom severity, self-reported depression, and a trend toward increased suicidal ideation within the UHR sample.

Conclusions:

OCS rates in UHR youth are well above estimated prevalence rates in normal populations, and commensurate with rates of comorbidity observed in schizophrenia. Although clinical diagnosis of OCD was not associated with later conversion to psychosis, OCS severity in UHR youth was associated with more acute symptomatic presentation, including more severe depression and suicidality.

Keywords: Prodrome, Ultra-high-risk, Psychosis, Obsessive–compulsive, Anxiety, Psychosocial functioning