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KMID : 1009020090070010009
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Clinical Psychopharmacology and Neuroscience
2009 Volume.7 No. 1 p.9 ~ p.14
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Schizophrenia with Obsessive-Compulsive Features: Review of Clinical and Conceptual Issues
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Hwang Michael-Y
kwon Jun-Soo
Yum Sun-Young
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Abstract
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Obsessive-compulsive (OC) phenomenon in schizophrenia has been clinically challenging and conceptually controversial over the years. However, significance and neurobiological implications remain poorly understood. Recent interest in schizophrenic comorbidity has been in part aided by progress in our understanding of neurobiology and modifications in DSM-IV that permitted additional diagnoses of axis-I disorder in patients with schizophrenia. In addition, advances in pharmacological treatment and understanding of neurobiological basis in OCD as well as other anxiety disorders increased clinician and research interests in schizophrenic patients with OC phenomena. However, earlier restrictive diagnostic concepts and yet to be clarified clinical and neurobiological implications of the OC phenomena in schizophrenia continues to present challenge in clinical practice. In early years the OC symptom was thought to be rare in patients with schizophrenia and when it occurs it was thought to be associated with benign clinical courses and better outcome. This belief, however, was contended in 1990’s with establishment of neurobiological basis of the OCD. Researchers have subsequently noted greater prevalence rates and worse clinical course and outcome. Controlled studies with specific anti-OCD pharmacotherapy and new generation antipsychotic treatment have also been conducted in recent years. Further evidences are needed to explore the neurobiological basis and clinical significance of OC phenomena within the context of broader schizophrenic spectrum disorder and its pathophysiology.
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KEYWORD
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Schizophrenia, Obsessive-compulsive disorder, Comorbid, Diagnosis, Treatment
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