Suicidality in schizophrenic patients with and without obsessive-compulsive disorder.

This report examines the suicidal behaviour in subjects with schizophrenia who have (N=24) and do not have comorbid Obsessive-Compulsive Disorder (OCD) (N=33). The patients with OCD-schizophrenia were more likely to have a previous history of suicidal attempts, and ideations. The number of previous suicidal attempts were significantly higher in patients with OCD-schizophrenia than in patients with non-OCD schizophrenia. The patients with a history of previous suicide attempts were more likely to have a comorbid diagnosis of OCD. Compulsive symptoms were significant predictors of suicide attempt among patients with schizophrenia. Our preliminary findings may suggest that obsessive-compulsive symptoms may account for the emergence of suicidality in patients with OCD-schizophrenia.

[Traumatic life events and problem solving skills in psychiatric outpatients: relationships with suicidal behavior]. / Ayaktan Tedavi Edilen Psikiyatri Hastalarinda Travmatik Yasam Olaylari ve Sorun Cözme Becerileri: Intihar Davranisiyla Iliskisi.

OBJECTIVE: To investigate the prevalence and the relationship of traumatic life events and problem solving skills to suicidal behavior in a group of psychiatric outpatients. METHOD: The study was conducted with 121 (57 % women) psychiatric outpatients. Patients who accepted participation filled in a questionnaire that contained questions about socio-demographics, clinical features, suicidal behavior, traumatic life-events, and a problem-solving inventory. Data were analyzed by means of t-tests, chi-square tests, one-way analysis of variance and multiple logistic regression analyses. RESULTS: Of the patients, 43.2 % (47.8 % women) reported having thought and 28.7 % (29.7 % women) reported having attempted suicide. 75.4 % of the sample experienced at least one traumatic life-event. On average, a person experienced approximately 2 (SD = 1.7) traumatic events. Two logistic regression analyses showed that inefficient problem solving was an independent predictor of both suicidal thoughts and attempts. Number of traumatic events appeared to be an independent predictor of suicidal attempts after the problem solving skills. In accordance with diathesis-stress model, both suicidal thoughts and attempts were found to be most frequent among persons with inefficient problem solving skills and who were also exposed to a large amount of traumatic life events. CONCLUSION: Suicidal behavior and traumatic life events are common among psychiatric patients. Findings indicate that inefficient problem solving may be an independent predictor of both suicidal ideation and attempts. Suicidal behavior, traumatic life-events and problem solving skills should be addressed during psychiatric assessment. Study findings imply that problem solving therapy may be an important approach that can be used for the treatment of psychiatric patients exhibiting suicidal behavior.

Schizo-obsessive and obsessive-compulsive disorder: comparison of clinical characteristics and neurological soft signs.

The purpose of the study was to examine whether schizophrenia with obsessive-compulsive disorder (OCD) represents a severe form of OCD-spectrum disorders on the basis of neurological soft signs (NSS) and obsessive-compulsive (OC) symptoms. Sixteen patients with OCD-schizophrenia, 25 OCD patients and 23 healthy controls (HC) were studied. Scales for the Assessment of Positive (SAPS) and Negative Symptoms (SANS), Clinical Global Impressions Scale and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) were used to assess the schizophrenic and OC symptomatology. NSS were evaluated with the Neurological Evaluation Scale (NES). OCD-schizophrenics had significantly higher scores on total NES than HC. The patients with OCD were more likely to have total Y-BOCS and subscale scores of compulsions than patients with OCD-schizophrenia. The rate of symmetry obsessions and cleaning/washing compulsions were significantly higher in patients with OCD compared to OCD-schizophrenics. We have found no correlation of OC symptoms with schizophrenic symptomatology. Our findings may suggest that OCD-schizophrenia is a distinct subtype of schizophrenia, not a more severe form of OCD-spectrum disorder.

Neurological soft signs in schizophrenic patients with obsessive-compulsive disorder.

The purpose of this study was to examine neurological soft signs (NSS) in schizophrenic patients with obsessive-compulsive disorder (OCD). Neurological soft signs were assessed in 15 schizophrenic patients with OCD (OCD-schizophrenia), 38 schizophrenia patients without OCD (non-OCD-schizophrenia), and 24 healthy controls (HC) by means of the Neurological Evaluation Scale (NES). The OCD-schizophrenia group had significantly higher scores on total and subscales of 'sensory integration' and 'others' of NES than the HC group. Subscale scores of 'sequencing of motor acts' in-non-OCD-schizophrenia patients were significantly higher compared to OCD-schizophrenia patients. Total NES scores of both groups were significantly correlated with Scale for the Assessment of Negative Symptoms (SANS) scores. Only the subscale of 'sequencing of motor acts' was significantly correlated with SANS within the OCD-schizophrenia group. These results suggest that NSS do not significantly differ between schizophrenia patients with and without OCD, contrary to expectations. The NES scores in OCD-schizophrenic patients do not appear to be related to a more severe form of schizophrenia. Neurological signs and negative symptoms in schizophrenia patients with and without OCD may be considered as neurodevelopmental predisposing factors. Further research is required in schizophrenia patients with OCD to investigate the relationships between NSS and several neuroimaging or neuropsychological findings, constituting a subgroup within the schizophrenia spectrum.