CNS Spectrums

Original Research

Hypochondriasis and obsessive-compulsive disorder in schizophrenic patients treated with clozapine vs other atypical antipsychotics

Giacomo Grassia1 c1, Lorenzo Polia1, Andrea Cantisania1, Lorenzo Righia2, Gabriella Ferraria1 and Stefano Pallantia1

a1 Department of Neuroscience, University of Florence, AOU Careggi, Florence, Italy

a2 Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy

Abstract

Objective The aim of the study was to investigate the prevalence rates of obsessive-compulsive disorder (OCD) and hypochondriasis in schizophrenic patients treated with atypical antipsychotics (AAPs) and to investigate the different comorbidity rates of OCD and hypochondriasis between clozapine-treated patients and patients treated with other AAPs.

Methods We therefore recruited 60 schizophrenic patients treated with clozapine or other AAPs. We assessed the prevalence rates of OCD or OC symptoms and hypochondriasis or hypochondriac symptoms in the whole group of patients and in clozapine-treated patients versus patients treated with other AAPs.

Results Schizophrenic patients had a higher comorbidity rate of OCD (26.6% vs 1–3%) and hypochondriasis (20% vs 1%) than the general population. These comorbidities were more frequent in schizophrenic patients treated with clozapine versus patients treated with other AAPs (36.7% vs 16.7% and 33.3% vs 6.7%). Clozapine-treated patients showed a higher mean Y-BOCS and HY-BOCS score when compared to patients treated with other AAPs (10.90 vs 5.90, p = .099; 15.40 vs 8.93, p = .166). A statistical significant correlation was found between the Y-BOCS and HY-BOCS scores of the whole group (r = .378, p = 0.03). Furthermore, we found an inverse correlation between the global level of functioning and the diagnosis of hypochondriasis (p = .048) and the severity of hypochondriac symptoms (p = .047).

Conclusions Hypochondriasis could represent an important clinical feature of schizophrenic patients treated with atypical antipsychotics, and further research is needed in this field.

(Received July 24 2013)

(Accepted September 12 2013)

Key words

  • Atypical antipsychotics;
  • clozapine;
  • health anxiety;
  • hypochondriasis;
  • obsessive-compulsive disorder;
  • schizophrenia

Correspondence

c1 Address for correspondence: Giacomo Grassi, MD, Department of Neuroscience, University of Florence, AOU Careggi, Via delle Gore 2H, 50134, Florence, Italy. (Email: giacomograssimd@gmail.com)

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