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Cognitive behavioural therapy for obsessive-compulsive symptoms in schizophrenia

Published online by Cambridge University Press:  23 July 2013

Frederike Schirmbeck  and
Mathias Zink
Frederike Schirmbeck*
Affiliation:
Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
Mathias Zink
Affiliation:
Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
*
*Author for correspondence: F. Schirmbeck, Dipl.Psych., Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, P.O. Box 12 21 20, D-68072 Mannheim, Germany. (email: frederike.schirmbeck@zi-mannheim.de).
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Abstract

Obsessive-compulsive symptoms (OCS) are a common phenomenon in patients with schizophrenia and are associated with additional clinical and functional impairments. So far treatment approaches have been limited to mainly pharmacological interventions with restricted effectiveness. Because cognitive behavioural therapy (CBT) is considered treatment of first choice for patients with primary obsessive-compulsive disorder (OCD), it seems compelling to consider it as a treatment option for comorbid OCS in schizophrenia. This research was conducted in order to investigate the theoretical and empirical basis for CBT in the treatment of comorbid OCS/OCD in schizophrenia. A comprehensive review and analysis of published literature was performed. Outcome measures from case-reports and a case-series showed favourable results with a significant reduction of symptom severity in 24/30 patients treated with CBT and exposure and response prevention (ERP) or ERP alone. CBT appears to offer a valuable opportunity to reduce symptom severity in this highly impaired group of patients. Based on these results and with a strong focus on tolerability concerns, suggestions for possible CBT approaches for the comorbid group are proposed. Further research within this field and systematic clinical evaluations are highly desirable.

Keywords

Cognitive behavioural therapycomorbidityschizophreniaobsessive compulsive
Type
Review
Information
the Cognitive Behaviour Therapist , Volume 6 , 2013 , e7
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

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References

Recommended follow-up reading

Hwang, MY, Kim, SW, Yum, SY, Opler, LA (2009). Management of schizophrenia with obsessive compulsive features. Psychiatric Clinics of North America 32, 835–851.Google Scholar
Schirmbeck, F, Zink, M (2012). Clozapine-induced obsessive-compulsive symptoms in schizophrenia: a critical review. Current Neuropharmacology 10, 88–95.Google Scholar

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