[Obsessive-compulsive symptoms in schizophrenia during treatment with clozapine and conventional antipsychotic drugs]

INTRODUCTION

We compare the prevalence of obsessive-compulsive symptoms in schizophrenic patients in treatment with clozapine and those who receive classic antipsychotic drugs.

METHOD

Outpatients with schizophrenia treated with clozapine (n = 56) or classic antipsychotic drugs (n = 54) at the Honorio Delgado-Hideyo Noguchi Specialized Institute in Mental Health (Lima-Peru), were evaluated for the presence of obsessive-compulsive symptoms by means of the Obsessive-Compulsive Disorder Module of Structured Clinical Interview for DSM-IV and Yale-Brown Obsessive-Compulsive Symptoms Checklist.

RESULTS

46.4 % of patients treated with clozapine presented obsessive-compulsive symptoms while this occurred in 20.4 % of those with classic antipsychotic drugs (p = 0.005). In addition, 21.4 % of patients with clozapine and 13 % of those treated with classic antipsychotics presented obsessive-compulsive disorder according to DSM-IV criteria (p = 0.31).

CONCLUSION

In schizophrenic patients, treatment with clozapine is associated with a higher rate of obsessive-compulsive symptoms than treatment with classic antipsychotic drugs.

[Validation of a version in Spanish of the Yale-Brown Obsessive-Compulsive Scale]

INTRODUCTION

The objective of this study is to validate a version in Spanish of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).

METHOD

We administered to 20 patients with obsessive-compulsive disorder (OCD) the Maudsley Obsessive-Compulsive Inventory (MOI) and a version in Spanish of the Y-BOCS. The application of the last one was performed by an interviewer, filmed, and then watched and rated by other 4 observers. In addition, the opinion of the treating psychiatrist about the severity of the patient's symptoms was registered. The interviewer and the observers were named raters.

RESULTS

The mean scores of the Y-BOCS assigned by the 4 observers were from 18.35 to 19.55; the maximum scores, from 34 to 35; and the minimum scores, from 1 to 5. The Pearson's correlations between raters were significant for all cases (r>0.86 and p<0.001). For all raters, Y-BOCS scores significantly correlated with MOI scores (p<0.001) and the opinion of the treating psychiatrist (p<0.05). We did not find significant correlation between the last one and MOI scores. The Cronbach's coefficients ranged from 0.8789 to 0.9488.

CONCLUSIONS

The Spanish version of the Y-BOCS is reliable, homogeneous and valid for quantification of the obsessive-compulsive symptoms, and has more correlation with the opinion of the treating psychiatrist than the MOI.