OBSESSIVE-COMPULSIVE DISORDER (OCD) IN PATIENTS WITH FIRST-EPISODE PSYCHOSIS (FEP): A PROSPECTIVE STUDY

Objective: Obsessive compulsive disorder (OCD) is a severe condition tending to be chronic if untreated. Despite research indicating that OCD is a common co-morbidity in patients with psychotic disorders, there is sparse systematic knowledge about the clinical course in patients with psychosis and comorbid OCD. To compare, one year after the first psychotic episode (FEP), changes in a) psychotic symptoms and b) global functioning and global symptoms (GAFS) in patients with and without comorbid OCD. Method: Two hundred and forty six fep-patients who were consecutively referred to a special unit for psychosis, were screened for psychosis as well as comorbid diagnoses at admission. To ensure the quality of the OCD-diagnostics, there was a post-hoc reassessment of all the patients based on information from SCID-I, panss and full medical records. The positive and negative syndrome scale (PANSS) and Global assessment of functioning (GAF-F and GAF-S), were employed to evaluate symptom severity at admission and one-year follow-up. Results: Despite no differences between the groups in psychotic symptoms or general functioning at admission, patients with comorbid OCD showed significantly less improvement in global function and symptom level from inclusion to one-year follow-up, even when depression was controlled for. Conclusions: The findings suggest that comorbid OCD in FEP may be associated with a more negative course of GAF-F and GAF-S, even though the OCD-group responded adequately to the antipsychotic treatment. Whether interventions specifically targeting the OCD would have changed the level of symptoms and functioning one year after the fep, is unknown. more studies focusing on diagnostic challenges combined with evidence based treatment is warranted.