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obsessive compulsive disorder or schizophrenia

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Postby Guest » Fri Aug 19, 2005 6:24 am

yfguitarist wrote:
luis wrote:
yfguitarist wrote:
luis wrote:
yfguitarist wrote:Hmm...well, I believe, well, know I have OCD. But my beliefs could be held in some people's eyes as psychotic delusions, because they're completely irrational. So, I don't know.


Do you hear voices ? What kind of psychotic delusions have you got ? I am curious about it ...

I did hear voices for a time.

I constantly believe that I'm going to get sick, even though this belief goes against all previous experiences I've had. Some people think it's a delusion, some people think it's a phobia. Either way it's uncontrollable

Example (not specific, but in general): If someone is nervous about riding a roller coaster, and they do it, they're like, "That wasn't so bad!" and are over their fears.
In my case, I'll be nervous, I'll do it, say, "That wasn't so bad!" and "forget" the next time I ride a roller coaster, and the fear starts over every time.


I looks like you have OCD and you've had the first signs of schizophrenia, the prodomal symptoms. I hope I am wrong.

Interesting. I already knew about the OCD even though I haven't been diagnosed or even seen a psychiatrist. I believed that I definitely had schizophrenia for a while, then when the symptoms went away, I stopped believing. although they could come back.


I have had schizophrenia for 10 years without knowing it and it happened the same as you, when the symptoms went away i stopped believing and stopped with the meds. Later on the symptoms came back ... At the end I realized that I was mentally ill and since 2 years ago that I keep on taking my meds, though I am already ###$ up :-(
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Postby yfguitarist » Fri Aug 19, 2005 6:20 pm

Anonymous wrote:
yfguitarist wrote:
luis wrote:
yfguitarist wrote:
luis wrote:
yfguitarist wrote:Hmm...well, I believe, well, know I have OCD. But my beliefs could be held in some people's eyes as psychotic delusions, because they're completely irrational. So, I don't know.


Do you hear voices ? What kind of psychotic delusions have you got ? I am curious about it ...

I did hear voices for a time.

I constantly believe that I'm going to get sick, even though this belief goes against all previous experiences I've had. Some people think it's a delusion, some people think it's a phobia. Either way it's uncontrollable

Example (not specific, but in general): If someone is nervous about riding a roller coaster, and they do it, they're like, "That wasn't so bad!" and are over their fears.
In my case, I'll be nervous, I'll do it, say, "That wasn't so bad!" and "forget" the next time I ride a roller coaster, and the fear starts over every time.


I looks like you have OCD and you've had the first signs of schizophrenia, the prodomal symptoms. I hope I am wrong.

Interesting. I already knew about the OCD even though I haven't been diagnosed or even seen a psychiatrist. I believed that I definitely had schizophrenia for a while, then when the symptoms went away, I stopped believing. although they could come back.


I have had schizophrenia for 10 years without knowing it and it happened the same as you, when the symptoms went away i stopped believing and stopped with the meds. Later on the symptoms came back ... At the end I realized that I was mentally ill and since 2 years ago that I keep on taking my meds, though I am already ###$ up :-(


But I'm not on meds
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Postby luis » Fri Aug 19, 2005 7:33 pm

yfguitarist wrote:...
But I'm not on meds


You always have the choice, but medicine is thought to help you. Anyway, it's your choice and it has to be respected.
luis
 

Postby yfguitarist » Sun Aug 21, 2005 3:51 am

I just said that because he was comparing his experience to mine and he included that he was on meds. I'm not anti-meds at all.
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Postby lclosama » Sun Aug 21, 2005 11:53 am

yfguitarist wrote:I just said that because he was comparing his experience to mine and he included that he was on meds. I'm not anti-meds at all.


I am glad to hear that. BTW, what is your email address ? Mine is lclosama@terra.es.

Regards,
Luis
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Re: obsessive compulsive disorder or schizophrenia

Postby lclosama » Sun Aug 21, 2005 9:31 pm

luis wrote:Hi,

Since 94 that i have been diagnosed as obsessive compulsive but my illness got so worse in 2002 that i had auditive hallucinations (two voices talking to each other and voices commenting what i was thinking and doing). These hallucinations kept on for 8 months without treatment. After some time since i started treating my illness with zyprexa the voices disappeared.

Can this be a severe case of OCD o it's a case of schizophrenia ?

My psychiatrist believe that this is a case of severe OCD and these cases can have psychosic episodes. Is that true ?

Best regards,
Luis


Yesterday a psychiatrist told me that in my case i don't have schizophrenia and that what happened to me was a psychotic outbreak coming from the OCD.

I also spoke to an old neurologist-psychiatrist that I know and I told her my personal story and she thinks that I have OCD and psychotic outbreaks with pseudo hallucinations.

How can it be proved that it is only OCD with psychotic symptoms and not schizophrenia ?

Regards,
Luis
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Re: obsessive compulsive disorder or schizophrenia

Postby Guest » Mon Aug 22, 2005 6:07 am

lclosama wrote:
luis wrote:Hi,

Since 94 that i have been diagnosed as obsessive compulsive but my illness got so worse in 2002 that i had auditive hallucinations (two voices talking to each other and voices commenting what i was thinking and doing). These hallucinations kept on for 8 months without treatment. After some time since i started treating my illness with zyprexa the voices disappeared.

Can this be a severe case of OCD o it's a case of schizophrenia ?

My psychiatrist believe that this is a case of severe OCD and these cases can have psychosic episodes. Is that true ?

Best regards,
Luis


It has been postulated that obsessive compulsive disorder (OCD) lies in a continuum between schizophrenia and the neurotic disorders. Patients of pure OCD develop psychotic symptoms when there is a transient loss of insight or there is emergence of paranoid ideas. Depression is frequently associated with OCD, which could either be a complication of OCD or could be an independent coexisting disorder. In our study, 17 out of 52 OCD patients had psychotic features. Relatively more patients in the psychotic group were found to be single. They had higher scores on YBOCS BPRS and HDRS (SIGH-D) as compared to the OCD patients without psychotic features.76.47% of the patients with psychotic features also fulfilled the DSM III-R criteria for Major Depressive Disorder. The possible explanation and implication of the findings have been discussed in the light of relevant literature.



Yesterday a psychiatrist told me that in my case i don't have schizophrenia and that what happened to me was a psychotic outbreak coming from the OCD.

I also spoke to an old neurologist-psychiatrist that I know and I told her my personal story and she thinks that I have OCD and psychotic outbreaks with pseudo hallucinations.

How can it be proved that it is only OCD with psychotic symptoms and not schizophrenia ?

Regards,
Luis
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Postby lclosama » Mon Aug 22, 2005 1:00 pm

Hi,

Has anyone been diagnosed with OCD with psychotic symptoms ?

Does it have better prognosis than paranoid schizophrenia ?

Regards
Luis
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Postby luis » Mon Aug 22, 2005 8:29 pm

Hi all,

If you take a look at the first message in this thread of conversation (i asked myself whether i had ocd or schizophrenia) I finally I found out from three different psychiatrists (one from Spain, another one from Austria and another one from USA) that I don't have schizophrenia but OCD with psychotic symptoms.

My whole story is as follows :

My first OCD outbreak was when I was in the University, by that time my OCD got so worse that I had a psychotic outbreak and I made a real mess. Luckily it was not necessay to go to a mental hospital. We stopped the psychosis and OCD outbreak with Anafranil and Mellaril.

After getting the computer science degree i went to live in Barcelona and I worked there for about three years. After some months working I started thinking that my work colleagues were conspiring against me because i was too lazy. I started with meds again and the episode of OCD and paranoia stopped.

In 1999 I went to live to a flat and let a guy share the flat with me. After I while i got paranoid of him and i also got paranoid at work up to the point that in March 2000 I had to take the meds again (anafranil and mellaril). The paranoia remitted.

In 2000 I went to live and work to Austria and after some months living there i got paranoid of a colleague at work because I thought that he was saying that I was mad and I went to see a psychiatrist there and he gave me 40mg Prozac which didn"t help to stop the paranoia. In december 2000 I left the firm and I was without work.

In 2001 i started working as IT and everything went fine until my first holidays in Barcelona. When I left the Airport the paranoia started again. Many people were saying that i was crazy. Everywhere I went people was saying that. I was awful. I didnt" realize that that was paranoia this time and i didn"t go to see any psychiatrist. When I came back from my holidays the same thing happened in Austria, people everywhere was saying that I was mad. By that time I thought that I was in the newspapers or something like that because I couldn"t find a cause of what was happening to me. I started thinking againg that my work colleagues or my boss were conspiring against me. The paranoia was growing up fast. At the end of July 2002 I left the firm and in October I started hearing voices. There were two voices in the hause where I was living that were talking about what I was doing. I thought I had cameras in my apartment. Then the voices were even talking about what i was thinking and I thought that these two voices came from two parapsychologists in the hause. One time i even had the visual hallucination that saw FBI guy in the entrance door of my hause. The thing got worse and when i went to the cinema or to a bar people were reading my mind and repeating and commenting was I was thinking. It was unbelievable. I didn"t realize that I was getting very sick, and nobody noticed it. I also had the feeling that my thoughts were broadcasted to people. It was terrible. I even thought that people on TV were sending messages to me and I could communicate with them through telepathy.

In March 2003 I went on holidays to Spain and i went to see my psychiatrist and he saw that i had a psychotic outbreak without me telling me anything. I started on meds again but this time it didn"t help because I didn't take enough antipsychotic. I went back abroad and kept on wiht the same psychotic symptoms. I was even talking to myself thinking that i was talking to other people through telepathy.

In July 2003 I went back to Spain because I couldn"t bear anymore that situation I was living in Austria. Then I went to see my psychiatrist and he gave me 20mg Zyprexa and the paranoia stopped. Thanks God. I asked my psychiatrist if I had schizophrenia and he told me that I was just obsessive compulsive and that i had a psychotic outbreak. I went to see another psychiatrist and he told me that I was schizoaffective. By that time that made sense to me, more than the other theory.

In 2004 started working as IT again but i had already mild cognitive impairment and it was very difficult for me to keep on with my job. I could work until March 2005 and then i got the sick leave. In June the Social Security System board for disabilities stated that I was obsessive compulsive, i had paranoid schizophrenia (I told them that I heard voices ...). Since then that I am a pensionist. I don"t think i will ever work again as IT.

Now I take a lot of meds to keep the OCD under control.

The curious thing is that I have never been hospitalized. Perhaps it"s because I am not at all aggresive and I don"t get aggresive when I get paranoia. I don"t know.

Now I am doing quite well, I go everyday in the afternoon to a center in my town for mentally ill people and drugaddicts to play cards and other games and that"s the way I spend the time. It"s boring but it"s better than doing nothing.

So, that's my personal story. I am glad to hear from three different doctors that I only have OCD and not schizophrenia, as I mentioned in the beginning of this message. Thanks God.

Best regards,
Luis
luis
 

Postby luis » Tue Aug 23, 2005 8:54 pm

Please take a look at what I found if you want to know more about OC symptoms in schizophrenia :

Obsessive and Compulsive Symptoms in Schizophrenia Patients—From Neuropsychology to Clinical Typology and Classification
Ilya Reznik, M.D., Psychiatry Division, Herzog Memorial Hospital, affiliation of Hadassah Medical School-Hebrew University, Jerusalem, Israel, Moshe Kotler, M.D., Beer-Yakov Mental Health Center, affiliation of the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel and Abraham Weizman, M.D., Felsenstein Medical Research Center, affiliation of the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel

SIR: Paul H. Lysaker, Ph.D., et al.1 reported interesting findings that are in line with a previous report by the same research group.2 In their study, patients with prominent obsessive-compulsive symptoms (OCS) had higher levels of positive symptoms, emotional discomfort, and greater deficits in executive function than schizophrenia patients without significant OCS,2 which is consistent with literature suggesting that OCS in schizophrenia is associated with a graver clinical picture. In particular, patients with compulsions also had higher levels of negative symptoms than schizophrenia patients without significant compulsions, even when level of obsessions was controlled statistically.2 A recent study, which examined other neurocognitive domains, revealed that the obsessive compulsive (OC) group had more severe impairments in vigilance but demonstrated superior performance on a measure of visual memory.1

Taken together, these findings suggest that links demonstrated in these and other studies3–5 between OCS and clinical and neurocognitive features of schizophrenia have nonlinear and often unpredictable pattern, which raises the question of causality. Schizophrenia patients with concurrent OCS constitute an intriguing subgroup of individuals. The etiology of OC phenomena in schizophrenia remains unclear. There is significant overlap in the proposed functional circuits and dysfunction at the neurotransmitter level in OCD and schizophrenia, which may lead to co-expression of symptoms. The interactions are multiple and complex, especially in regard to the serotonin and dopamine pathways.6

Three main types of interrelation between OCS and psychotic disorder are described: 1) those whose OCS are independent from psychosis; 2) those whose OCS are partially related to their psychosis; and 3) those whose OCS represent a continuum of their psychosis. Clinically and anamnestically, we are able to distinguish three main subgroups of patients: 1) those who met the DSM-IV criteria for OCD before the development of schizophrenic process (so called "OCD-schizophrenia"); 2) those who began to exhibit OC symptoms around the onset (i.e. in prodromal phase) or at any time during the course of schizophrenia (so called "schizoobsessive disorder"); and 3) schizophrenic patients having transient OC symptoms on different stages of their disease, or under specific circumstances (infections, i.e streptococcal; iatrogenic, i.e. under some atypical neuroleptics, etc..7 Existence of these three groups may explain (at least, in part) the diversity in epidemiological data, clinical manifestations and course, neuropsychological correlates, outcomes of various prognoses and treatments.

It was shown, that preexisting OCD, at least in the early stages of schizophrenia, may have a "protective" effect on some psychotic symptoms and may be responsible for a less virulent course of illness and a higher level of functioning.8 On the other hand, schizo-obsessive patients are more disorganized, tended to have a more chronic course and a greater frequency of social and occupational impairment and a poor long-term outcome.1–6 For these groups, different treatment approaches should be applied. In order to demonstrate it, recently we had shown that schizo-obsessive patients need and benefit from neuroleptics as monotherapy.7 In contrast, antipsychotic monotherapy is often inefficient in OCD-schizophrenia patients and sometimes may worsen the OCS, so these patients should be treated concomitantly with specific antiobsessive agents, i.e. serotonin reuptake inhibitors.7

Concerning the appropriate instruments that should be used for assessing OCS in schizophrenia, the utility of Yale-Brown Obsessive Compulsive Scale as an optimal rating scale could be questionable due to possible difficulties to evaluate resistance and interference to repetitive thoughts and/or behavior in this kind of psychotic patients.3–6 Thus, new valid and reliable scale should be designed and psychometrically confirmed in order to assess properly the specific characteristics of OCS in the context of schizophrenia.

The findings and discussion of Lysaker at al.1,2 support our theoretical assumptions and preliminary typological classifications of OC-schizophrenia subtypes. Moreover, their study, suggested heterogeneity of the OC group and described unexpected experimental findings providing additional clinical-neuropsychological evidence to establishing the internal borders within the OC-schizophrenia spectrum category. We agree with the authors, that further research that will adequately monitor OC and psychotic symptoms, cognitive and psychophysiological functioning in a longitudinal design before the issues of causality can be addressed definitively, is warranted.
luis
 

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