Obsessive-Compulsive Symptoms in Treatment-Resistant Schizophrenia: Case Report

Background : Poyurovsky proposed the schizo-obsessive subtype in order to delineate a discrete subgroup of patients with schizophrenia with comorbid obsessive-compulsive symptoms, which cause a cumulative effect on functioning and poor prognosis. We aimed to exemplify the clinical challenges of treatment-resistant schizophrenia with obsessive-compulsive symptoms. Methods : Report a clinical case, evaluation with psychometric measures, and non-systematic literature review. Results : This work presents the case of a 43-year-old patient, with treatment-resistant schizophrenia, admitted to the Treatment-Resistant Schizophrenia Unit of Coimbra Hospital and University Centre. The positive, negative, and cognitive symptoms of schizophrenia co-occurred with distinct obsessive-compulsive symptoms. Primary obsessive-compulsive symptoms were present since the schizophrenia prodrome. Other obsessive-compulsive symptoms followed the delusional ideas. Clozapine-induced obsessive-compulsive symptoms appeared later. Conclusions: Accurate diagnosis of obsessive-compulsive symptoms enables their effective treatment.