Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Letter to the Editor   |    
Dr. Eisen and Colleagues Reply
Jane L. Eisen, M.D.; Douglas A. Beer, M.D.; Michele T. Pato, M.D.; Terri A. Venditto, R.N.; Steven A. Rasmussen, M.D.
Am J Psychiatry 1997;154:1635-a-1636.
text A A A

TO THE EDITOR: Dr. Werner's letter raises a question about the usefulness of assigning an additional diagnosis of OCD to schizophrenic patients who also have obsessions or compulsions. While a discussion of the relative benefits of a hierarchical nosological system is beyond the scope of this reply, we would like to comment on the difficulties that might arise from Dr. Werner's suggestion to add an obsessive-compulsive symptom modifier to the diagnosis of schizophrenia. There has been much interest recently in ascertaining the frequency with which obsessive-compulsive symptoms co-occur in psychotic disorders such as schizophrenia. It has been suggested that as many as 40% of patients with schizophrenia or schizoaffective disorder have obsessive-compulsive symptoms. Our concern is that using an obsessive-compulsive symptom modifier without clearly defined criteria may lead to nonhomogeneous populations for study (e.g., patients who are overly preoccupied or "obsess" about their delusions or patients who check repeatedly to make sure their phones are not being tapped).

We may have underestimated the frequency of obsessive-compulsive symptoms in the patients with schizophrenia whom we assessed because we required patients to meet the clearly defined DSM-IV criteria for OCD. However, ensuring a homogeneous patient population allows further investigation of important questions such as treatment response, course of illness, and prognosis. Pursuit of these questions may be muddied by the use of an obsessive-compulsive symptom modifier that does not have specific criteria.




CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe

Related Content
DSM-5™ Clinical Cases > Chapter 2.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 12.  >
DSM-5™ Handbook of Differential Diagnosis > Chapter 2.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 24.  >
Topic Collections
Psychiatric News
APA Guidelines