Clozapine-induced obsessive-compulsive symptoms in schizophrenia: Clinical and cognitive determinants of dysfunctional checking

被引：0

作者：

Biria, Marjan ^{[1
,2
,3
,4
]}

Banca, Paula ^{[1
,2
]}

Barnham, Isaac Jarratt ^{[5
,6
]}

Marzuki, Aleya A. ^{[1
,7
,8
,9
]}

Segarra, Nuria ^{[10
]}

Keser, Engin ^{[1
,11
]}

Sule, Akeem ^{[12
]}

Farrugia, Marija ^{[10
]}

Luo, Qiang ^{[13
]}

Fineberg, Naomi ^{[14
]}

Fernandez-Egea, Emilio ^{[2
,10
,15
]}

Robbins, Trevor W. ^{[1
,2
]}

机构：

[1] Univ Cambridge, Cambridge CB2 3EB, England

[2] Univ Cambridge, Cambridge CB2 3EB, England

[3] UCL, Div Psychiat, London, England

[4] UCL, Div Psychol & Language Sci, London, England

[5] Cambridgeshire & Peter borough NHS Fdn Trust, Cambridge Psychosis Ctr, Cambridge, England

[6] Univ Oxford, Pembroke Coll, Oxford OX1 1DW, England

[7] Eberhard Karls Univ Tubingen, Med Sch, Dept Psychiat & Psychotherapy, Tubingen, Germany

[8] Eberhard Karls Univ Tubingen, Univ Hosp, Tubingen, Germany

[9] German Ctr Mental Hlth DZPG, Tubingen, Germany

[10] Cambridgeshire & Peterborough NHS Fdn Trust, Fulbourn, England

[11] Kings Coll London, Genet & Dev Psychiat Ctr, London, England

[12] Univ Cambridge, Sch Clin Med, Dept Psychiat, Cambridge, England

[13] Fudan Univ, Inst Sci & Technol Brain Inspired Intelligence, Ctr Computat Psychiat, Shanghai 200433, Peoples R China

[14] Univ Hertfordshire, Hertfordshire Partnership Univ NHS Fdn Trust, Natl Hlth Serv, Hatfield, England

[15] Univ Cambridge, Dept Psychiat, Cambridge, England

来源：

PSYCHOLOGICAL MEDICINE | 2025年 / 55卷

基金：

英国惠康基金; 中国国家自然科学基金;

关键词：

checking; cognitive flexibility; OCD; schizophrenia; spatial working memory; WORKING-MEMORY; EXCESSIVE CHECKING; DISORDER; SCALE; NEUROPSYCHOLOGY; FLEXIBILITY; UNCERTAINTY; PERFORMANCE; VALIDATION; DRUG;

D O I：

10.1017/S0033291724003350

中图分类号：

B849 [应用心理学];

学科分类号：

040203 ;

摘要：

Background Obsessive-compulsive symptoms (OCS) emerge in a significant proportion of clozapine-treated schizophrenia patients, affecting social functioning and increasing depressive symptoms. This study investigates the underexplored cognitive mechanisms of clozapine-induced OCS, particularly focusing on dysfunctional checking behavior.Methods Clinical and cognitive profiles of OCS and their relationship to dysfunctional checking were investigated using a novel checking paradigm (image verification task or IVT) in four groups: clozapine-treated schizophrenia patients with clozapine-induced OCS (SCZ-OCS, n = 21) and without (SCZ-only, n = 15), patients with obsessive-compulsive disorder (OCD, n = 32) and IQ-matched healthy volunteers (HV, n = 30).Results Only SCZ-OCS patients showed a distinctive pattern of dysfunctional checking on the IVT. Compared with SCZ-OCS, SCZ-only patients exhibited functional checking while having equivalent deficits in executive cognition, clozapine dose, and treatment duration, though with less severe positive and depressive symptoms. In SCZ-OCS, dysfunctional checking was positively correlated with clozapine dose and working memory performance. By contrast, OCD patients' checking was positively related to intolerance of uncertainty. Checking in the OCD and SCZ-OCS groups was positively correlated with YBOCS-compulsion.Conclusion This study is the first to compare the distinct cognitive and clinical profiles of SCZ-OCS, SCZ-only, and OCD, with a focus on checking behavior, a major symptom in clozapine-treated patients. We introduced a novel and sensitive measure for checking, which showed dysfunctional checking only in SCZ-OCS patients treated with clozapine. These findings indicate that a subset of patients with schizophrenia with more severe positive symptoms and cognitive deficits are especially susceptible to OCD symptoms when treated with clozapine.

引用

页数：12

共 58 条

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