Obsessive Compulsive disorder (OCD) is a chronic and debilitating condition characterised by the presence of obsessions (i.e., recurrent, or intrusive thoughts or images) and/or compulsions (repetitive and ritualised behaviours carried out in an attempt to alleviate anxiety) (American Psychiatric Association, 2022). OCD is thought to affect 1-4% of adults in the general population (NICE, 2018). In contrast, psychotic disorders are classified as eight distinct diagnoses in the DSM-5-TR, each featuring a combination of hallucinations, delusions, disorganised speech, abnormal psychomotor behaviour and negative symptoms (American Psychiatric Association, 2022). It is estimated that psychotic disorders have a lifetime prevalence of 3% (Perälä et al, 2007).

OCD, when present in psychotic disorders, has been linked to complications in treatment of either condition (Cederlof et al, 2015). Additionally, this comorbidity is associated with increased symptom severity, decreased quality of life, more depressive symptoms and higher rates of suicidaility and overall poorer prognosis (Cunill et al., 2008; Lieuwe de Haan et al., 2012; Niendam et al, 2009; Sharma & Reddy, 2019). Some research has explored the cross-sectional relationship between OCD and psychosis. One study conducted in Sweden found that individuals diagnosed with OCD were 12 times likelier to have a diagnosis of psychosis (Cederlof et al, 2015). Similarly, within a population of individuals diagnosed with psychosis, 25% also presented with obsessive compulsive symptoms (OCS) and 15% met diagnostic criteria for OCD (Scotti-Muzzi & Saide, 2017). Whilst current literature documents cross-sectional links between the two disorders, there is a dearth of literature exploring whether OCD is prospectively associated with psychosis, or whether psychosis is prospectively associated with OCD. Additionally, whether this association is true for OCS and psychotic-like experiences. There is also very little known about the mechanisms which may explain this association. One research study found significant associations between the presence of delusions and obsessions as well as auditory hallucinations and compulsions, suggesting that they could share common mechanisms (Guillem et al, 2009). Through developing a better understanding of the association between OCD/OCS and psychosis/ psychotic experiences at a symptom level, psychological interventions may be adapted or developed for individuals who present with both.

This project proposes to re-use the dataset B2172 in order to explore the research question, whilst also requesting additional variables (please see exposures, outcomes and confounders for a list of the data to re-use request and new variables to request).

References:

American Psychiatric Association. (2022) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision, DSM-5-TR. American Psychiatric Association

Cederlöf, M., Lichtenstein, P., Larsson, H., Boman, M., Rück, C., Mikael Landén, & Mataix-Cols, D. (2014). Obsessive-Compulsive Disorder, Psychosis, and Bipolarity: A Longitudinal Cohort and Multigenerational Family Study. Schizophrenia Bulletin, 41(5), 1076–1083. https://doi.org/10.1093/schbul/sbu169

Cunill, R., Castells, X., & Simeon, D. (2008). Relationships Between Obsessive-Compulsive Symptomatology and Severity of Psychosis in Schizophrenia. The Journal of Clinical Psychiatry, 70(1), 70–82. https://doi.org/10.4088/jcp.07r03618

Guillem, F., Satterthwaite, J., Pampoulova, T., & Stip, E. (2009). Relationship between psychotic and obsessive compulsive symptoms in schizophrenia. Schizophrenia Research, 115(2-3), 358–362. https://doi.org/10.1016/j.schres.2009.06.004

Lieuwe de Haan, Sterk, B., & Renate. (2012). Presence of obsessive compulsive symptoms in first‐episode schizophrenia or related disorders is associated with subjective well‐being and quality of life. Early Intervention in Psychiatry, 7(3), 285–290. https://doi.org/10.1111/j.1751-7893.2012.00377.x

NICE. (2018) Obsessive-compulsive disorder: How common is it?

Niendam, T. A., Berzak, J., Cannon, T. D., & Bearden, C. E. (2009). Obsessive compulsive symptoms in the psychosis prodrome: Correlates of clinical and functional outcome. Schizophrenia Research, 108(1-3), 170–175. https://doi.org/10.1016/j.schres.2008.11.023

Perälä, J., Jaana Suvisaari, Saarni, S. I., Kimmo Kuoppasalmi, Erkki Isometsä, Pirkola, S., Timo Partonen, Annamari Tuulio-Henriksson, Jukka Hintikka, Tuula Kieseppä, Tommi Härkänen, Koskinen, S., & Jouko Lönnqvist. (2007). Lifetime Prevalence of Psychotic and Bipolar I Disorders in a General Population. Archives of General Psychiatry, 64(1), 19–19. https://doi.org/10.1001/archpsyc.64.1.19

Scotti-Muzzi, E., & Saide. O. L, (2016). Schizo-obsessive spectrum disorders: an update. CNS Spectrums, 22(3), 258–272. https://doi.org/10.1017/s1092852916000390

Sharma, L. P., & Reddy, J. (2019). Obsessive–compulsive disorder comorbid with schizophrenia and bipolar disorder. Indian Journal of Psychiatry, 61(7), 140–140. https://doi.org/10.4103/psychiatry.indianjpsychiatry_527_18