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Diagnostic progression to schizophrenia in 35,255 patients with obsessive–compulsive disorder: a longitudinal follow-up study

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Abstract

Evidence suggests a continuity between obsessive–compulsive disorder (OCD) and schizophrenia. However, the factors that may predict diagnostic progression from OCD to schizophrenia remain unclear. A total of 35,255 adolescents and adults with OCD (ICD-9-CM code: 300.3) were enrolled between 2001 and 2010 and followed up at the end of 2011 for the identification of de novo schizophrenia (ICD-9-CM code: 295). The Kaplan–Meier method was used to estimate incidence rates, and the Cox regression was used to determine the significance of candidate predictors. At the end of the 11-year follow-up period, the crude cumulative progression rate from OCD to schizophrenia was 6%, and the estimated progression rate totaled 7.80%. Male sex (hazard ratio: 1.23), obesity (1.77), autism spectrum disorder (1.69), bipolar disorder (1.69), posttraumatic stress disorder (1.65), cluster A personality disorder (2.50), and a family history of schizophrenia (2.57) also were related to an elevated likelihood of subsequent progression to schizophrenia in patients with OCD. Further study is necessary to elucidate the exact pathomechanisms underlying diagnostic progression to schizophrenia in patients with OCD.

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Acknowledgements

We thank Mr I-Fan Hu for his support and friendship.

Funding

The study was supported by grant from Taipei Veterans General Hospital (V106B-020, V107B-010, V107C-181, V108B-012, V110C-025, V110B-002), Yen Tjing Ling Medical Foundation (CI-109-21, CI-109-22, CI-110-30) and Ministry of Science and Technology, Taiwan (107-2314-B-075-063-MY3, 108-2314-B-075 -037, 110-2314-B-075-026, 110-2314-B-075-024-MY3). The funding source had no role in any process of our study. All authors have no financial relationships relevant to this article to disclose.

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Authors and Affiliations

  1. Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan

    Mu-Hong Chen, Shih-Jen Tsai, Chih-Ming Cheng, Tung-Ping Su & Ya-Mei Bai

  2. Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Mu-Hong Chen, Shih-Jen Tsai, Chih-Ming Cheng, Tung-Ping Su & Ya-Mei Bai

  3. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Tzeng-Ji Chen

  4. Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Tzeng-Ji Chen

  5. Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, No. 60, Xinmin Road, 11243, Taipei, Taiwan

    Chih-Sung Liang

  6. Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan

    Chih-Sung Liang

  7. Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan

    Tung-Ping Su

  8. Department of Medical Research, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 112, Taiwan

    Ya-Mei Bai

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Drs MHC, YMB, and CSL designed the study and wrote the manuscript draft; Drs SJT, CMC, TPS and TJC performed the literature reviews and revised the manuscript; Dr MHC performed the statistical analysis; all authors reviewed the final manuscript and agreed for the publication.

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Correspondence to Chih-Sung Liang or Ya-Mei Bai.

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Chen, MH., Tsai, SJ., Liang, CS. et al. Diagnostic progression to schizophrenia in 35,255 patients with obsessive–compulsive disorder: a longitudinal follow-up study. Eur Arch Psychiatry Clin Neurosci 273, 541–551 (2023). https://doi.org/10.1007/s00406-021-01361-w

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