CNS Drugs

, Volume 18, Issue 14, pp 989–1010 | Cite as

Obsessive-Compulsive Disorder in Schizophrenia

Clinical Characteristics and Treatment
  • Michael Poyurovsky
  • Abraham Weizman
  • Ronit Weizman
Therapy In Practice


There is a considerable overlap of schizophrenia and obsessive-compulsive disorder (OCD) in the structural and functional brain abnormalities involved, role of the dopamine/serotonin neurotransmitter systems, and some demographic and clinical characteristics. Although OCD co-occurs in a substantial proportion of schizophrenia patients, a systematic evaluation of the clinical features and treatment of this population is lacking. This review critically evaluates findings of recent studies pertaining to the rate of occurrence of OCD or obsessive-compulsive symptoms (OCS) in schizophrenia and the clinical characterisation of the schizo-obsessive subtype. Specifically, interrelationships between obsessive-compulsive and schizophrenic symptoms in terms of temporal relationships and their association with specific schizophrenia subtypes and the effect of OCS on the severity of schizophrenia symptoms are addressed. In the absence of evidence-based data, tentative therapeutic approaches in this difficult-to-treat patient subgroup are suggested. These include monotherapy with atypical antipsychotic agents or a combination of either typical or atypical antipsychotic s with SSRIs or clomipramine. The clinical characteristics of antipsychotic-induced OCS/OCD are also presented to facilitate identification and management of this rare but clinically significant adverse effect. Finally, future directions of research in schizophrenia-OCD comorbidity relevant to clinical practice are discussed.


Schizophrenia Clozapine Risperidone Olanzapine Fluvoxamine 



The authors appreciate the editorial assistance of Rena Kurs from Sha’ar Menashe Mental Health Center and Gloria Ginzach from Beilinson Medical Center. The authors had no conflicts of interest relevant to the contents of this manuscript, and there were no sources of funding involved in the preparation of this manuscript.


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Copyright information

© Adis Data Information BV 2004

Authors and Affiliations

  • Michael Poyurovsky
    • 1
    • 2
  • Abraham Weizman
    • 3
    • 4
    • 5
  • Ronit Weizman
    • 5
    • 6
  1. 1.Tirat Carmel Mental Health CenterTirat CarmelIsrael
  2. 2.Rapapport Faculty of MedicineTechnion Institute of TechnologyHaifaIsrael
  3. 3.Laboratory of Biological PsychiatryFelsenstein Medical Research Center, Beilinson CampusPetah TiqvaIsrael
  4. 4.Geha Mental Health CenterPetah TiqvaIsrael
  5. 5.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  6. 6.Tel Aviv Mental Health CenterTel AvivIsrael

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