TO THE EDITOR: When does the presence of symptoms warrant a diagnosis? This is an important question raised by Jane L. Eisen, M.D., and colleagues (1). Obsessive-compulsive symptoms occur in schizophrenia, as do depressive symptoms, manic symptoms, and phobic symptoms among others. The emergence of obsessive-compulsive symptoms after infections and other processes that may impinge on brain function makes it reasonable to hypothesize that the same could be the case with schizophrenia. Identification of obsessive-compulsive symptoms in schizophrenia allows treatment to be modified accordingly. However, we need to address the implications of making a second diagnosis, establishing obsessive-compulsive disorder (OCD) as a comorbid condition rather than considering the symptoms as associated with schizophrenia.