Diagnosis and treatment of a patient with both psychotic and obsessive-compulsive symptoms

Am J Psychiatry. 2010 Jul;167(7):754-61. doi: 10.1176/appi.ajp.2009.09070997.

Abstract

When a patient presents with both psychotic and obsessive-compulsive symptoms, the clinician is faced with a differential diagnosis that includes comorbid schizophrenia and obsessive-compulsive disorder (OCD), OCD with poor insight, and schizophrenia with antipsychotic-induced obsessive-compulsive symptoms. If the psychotic symptoms are subthresh-old or attenuated in form, the individual may have OCD and putative prodromal schizophrenia. The authors present a case to outline a strategy for differentiating among these possible diagnoses and for optimizing treatment.

Publication types

  • Case Reports
  • Clinical Conference

MeSH terms

  • Age of Onset
  • Antipsychotic Agents / therapeutic use
  • Diagnosis, Differential
  • Drug Therapy, Combination
  • Humans
  • Male
  • Obsessive-Compulsive Disorder / complications*
  • Obsessive-Compulsive Disorder / diagnosis
  • Obsessive-Compulsive Disorder / drug therapy
  • Psychotic Disorders / diagnosis
  • Schizophrenia / complications*
  • Schizophrenia / diagnosis
  • Schizophrenia / drug therapy
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Treatment Outcome
  • Young Adult

Substances

  • Antipsychotic Agents
  • Serotonin Uptake Inhibitors