Obsessive–compulsive symptoms and overall psychopathology in psychotic disorders: longitudinal assessment of patients and siblings
Schirmbeck, Frederike; Swets, Marije; Meijer, Carin J.; Zink, Mathias; de Haan, Lieuwe; Kahn, René S.; van Os, Jim; Bruggeman, Richard; Cahn, Wiepke; Bartels-Velthuis, Agna A.; Myin-Germeys, Inez; GROUP Investigators
(2018) European Archives of Psychiatry and Clinical Neuroscience, volume 268, issue 3, pp. 279 - 289
(Article)
Abstract
The course of obsessive–compulsive symptoms (OCS) and its association with alterations in other clinical variables in patients with psychotic disorders is insufficiently known. Patients (n = 602) and unaffected siblings (n = 652) from the Dutch Genetic Risk and Outcome of Psychosis (GROUP) study were investigated at baseline and after 3 years. Participants were assigned
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to four groups based on the course of OCS over time: no-OCS, persistent OCS, initial OCS and de novo OCS. In addition to cross-sectional comparisons, longitudinal associations between changes in OCS and symptoms of schizophrenia and general functioning were investigated. Patients with co-occurring OCS reported significantly higher severity of psychotic and affective symptoms as well as lower overall functioning compared to patients without OCS. These differences were stable over time for patients reporting persistent OCS. Subsequent repeated measure analysis revealed significant interaction effects for groups reporting changes in their OCS. Whereas the group with remission of initial OCS showed significant improvement in positive symptoms, emotional distress and functioning, the de novo group showed no significant change in these variables, but rather reported stable higher psychopathology. Similar results were found on a subclinical level in siblings. Patients with co-occurring OCS present a more severe clinical picture, especially if symptoms persist over time. The remission of OCS was associated with overall improvement, whereas individuals with de novo OCS already reported higher clinical impairment before OCS onset. More research is needed to elucidate causal pathways and to develop effective interventions for persistent comorbid OCS.
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Keywords: Comorbidity, Longitudinal, Obsessive–compulsive, Psychosis, Schizophrenia, Psychiatry and Mental health, Biological Psychiatry, Pharmacology (medical)
ISSN: 0940-1334
Publisher: D. Steinkopff-Verlag
Note: Funding Information: Otsuka, Lundbeck, Astra Zeneca, Eli-Lilly, Janssen Cilag, Roche, Ferrer and Trommsdorff. L. de Haan has received speaker’s bureau honoraria from Eli Lilly, Janssen-Cilag Pharmaceuticals and Astra-Zeneca BV and an investigator initiated unrestricted research grant from Eli Lilly. Funding Information: We would like to thank patients and siblings who took part in this study. This work was supported by a Grant from the Geestkracht program of the Dutch Health Research Council (ZonMw, Grant No. 10-000-1002). F. Schirmbeck was supported by a fellowship within the Postdoc Program of the German Academic Exchange Service (DAAD). Ren? S. Kahn (Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, The Netherlands), Jim van Os (Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands), Richard Bruggeman (University of Groningen, University Center for Psychiatry, University Medical Center Groningen, The Netherlands), Wiepke Cahn (Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, The Netherlands), Carin Meijer, Lieuwe de Haan (Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands) Agna A. Bartels-Velthuis (University of Groningen, University Center for Psychiatry, University Medical Center Groningen, The Netherlands), Inez Myin-Germeys (Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands, Center for Contextual Psychiatry, Department of Neuroscience, Catholic University Leuven, Belgium). GROUP investigators are named in the acknowledgements. All authors have declared that there are no conflicts of interest in relation to the subject of this study. F. Schirmbeck was supported by a fellowship within the Postdoc Program of the German Academic Exchange Service (DAAD). M. Zink has received unrestricted scientific grants of the German Research Foundation (DFG), Servier and Trommsdorff and has further received speaker and travel support from Pfizer Pharma GmbH, Bristol-Myers Squibb, Otsuka, Lundbeck, Astra Zeneca, Eli-Lilly, Janssen Cilag, Roche, Ferrer and Trommsdorff. L. de Haan has received speaker's bureau honoraria from Eli Lilly, Janssen-Cilag Pharmaceuticals and AstraZeneca BV and an investigator initiated unrestricted research grant from Eli Lilly. Funding Information: Acknowledgements We would like to thank patients and siblings who took part in this study. This work was supported by a Grant from the Geestkracht program of the Dutch Health Research Council (ZonMw, Grant No. 10-000-1002). F. Schirmbeck was supported by a fellowship within the Postdoc Program of the German Academic Exchange Service (DAAD). Funding Information: Conflict of interest All authors have declared that there are no conflicts of interest in relation to the subject of this study. F. Schirmbeck was supported by a fellowship within the Postdoc Program of the German Academic Exchange Service (DAAD). M. Zink has received unrestricted scientific grants of the German Research Foundation (DFG), Servier and Trommsdorff and has further received speaker and travel support from Pfizer Pharma GmbH, Bristol-Myers Squibb, Publisher Copyright: © 2016, The Author(s).
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