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Objectives

Comorbid obsessive-compulsive (OC) symptoms in individuals with a primary diagnosis of schizophrenia are related to poorer cognitive performance and functional outcomes, but no study to date has assessed whether this comorbidity might also have implications for social cognition. The aim of the present study was to provide the first test of this possibility.

Design and methods

Individuals with schizophrenia (= 34) and demographically matched non-clinical controls (= 44) were assessed on two of the most important aspects of social cognitive function (1) facial affect recognition and (2) theory of mind, alongside more standard measures of cognitive function.

Results

The presence of OC symptoms was related to poorer performance on some of the cognitive measures, as well as one of the social cognitive measures (facial affect recognition). However, these relationships disappeared after controlling for scores on more general indices of schizophrenia psychopathology.

Conclusions

The presence of OC symptoms in schizophrenia is not only associated with increased cognitive impairment but also increased difficulties with at least some aspects of social cognitive function. However, these relationships appear to reflect the elevated levels of psychopathology seen in this cohort more generally, rather than being uniquely attributable to OC symptomatology.

Practitioner Points

  • The presence of obsessive-compulsive (OC) symptoms in chronic schizophrenia is not only associated with greater cognitive impairment but also with increased difficulties in at least some aspects of social cognitive function.
  • These increased difficulties appear to reflect a more severe presentation of schizophrenia overall rather than the presence of OC symptoms specifically.
  • A limitation of this research design was the inclusion of only chronic, medicated participants with schizophrenia. Individuals at early or more acute phases of schizophrenia may present with a different profile of impairment.
  • Further research is needed to assess whether or not different results emerge where there is a comorbid diagnosis of obsessive-compulsive disorder (as opposed to sub-clinical OC symptoms).