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Neurological Soft Signs in Schizophrenia Patients With Obsessive-Compulsive Disorder

Received February 22, 2006; revised June 1, 2006; accepted June 5, 2006. Dr. Poyurovsky is affiliated with the Research Unit, Tirat Carmel Mental Health Center, Tirat Carmel, Israel, and Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel. Drs. Pashinian, Viosburd, and Stryjer and Ms. Levi are affiliated with the Research Unit, Tirat Carmel Mental Health Center, Tirat Carmel, Israel. Dr. Ronit Weizman is affiliated with the Clinical Psychopharmacology Unit, the Community Mental Health Center, and the Sackler Faculty of Medicine, Tel Aviv, Israel. Dr. Fuchs is affiliated with the Department of Statistics and Operations Research, Beverley and Raymond Sackler Faculty of Exact Sciences, Tel-Aviv University, Tel-Aviv, Israel. Dr. Abraham Weizman is affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, and the Laboratory of Biological Psychiatry, Felsenstein Medical Research Center, Geha Psychiatric Hospital, Petah Tiqva, Israel. Address correspondence to Dr. Poyurovsky, Tirat Carmel Mental Health Center, 9 Eshkol Street, Tirat Carmel 30200, Israel; poyurovs{at}tx.technion.ac.il (e-mail).

Obsessive-compulsive disorder is a prevalent and clinically significant phenomenon in schizophrenia patients. Both schizophrenia and obsessive-compulsive disorder (OCD) are considered to be neurodevelopmental disorders sharing dysfunctional frontal-subcortical circuitry. Using the Neurological Evaluation Scale (NES), the authors assessed neurological soft signs in 59 patients who met DSM-IV criteria for both schizophrenia and OCD. The two schizophrenia groups (with and without OCD) scored higher than the comparison group but did not significantly differ from one another on any of the NES subscales. The first-episode patients in both groups scored similarly to patients with repeated hospitalizations on all NES subscales. Notably, the OCD patients scored similarly to the two schizophrenia groups on the NES motor sequencing subscale. The author's findings support the notion that neurological soft signs are independent markers of brain dysfunction detectable early in the course of schizophrenia. However, they are of limited value as a putative endophenotype in a search for specific etiological mechanisms underlying a schizo-obsessive subgroup of schizophrenia.

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