Schizo-Obsessive Disorder

Schizo-Obsessive Disorder

by Michael Poyurovsky. New York, NY, Cambridge Medicine, Cambridge University Press, 2013, 236 pages, $99.00 (hardback).

This book, focusing exclusively on the comorbid condition of obsessive-compulsive (OC) symptoms in schizophrenia, is a welcomed addition among books dedicated to schizophrenia. It is a detailed account of the interface between OC and schizophrenia and is nicely written so as to appeal to the specialist in schizophrenia as well as to the general psychiatrist. Indeed, the book reflects well the growing emphasis on psychiatric and medical comorbidities and on tailoring treatments to these seemingly distinct subgroups. Accordingly, I was delighted to have the opportunity to read this book, aptly titled Schizo-Obsessive Disorder.

It covers a broad array of aspects of the topic, reflecting most current knowledge in research and clinical care of patients with "schizo-obsessive disorder" and with due regard to both pharmacologic and psychosocial treatments for these patients. The inclusion of multiple case vignettes is particularly appealing and serves well to highlight distinct aspects of symptoms and illness course. An area of consideration for a future edition is forensics and whether OC symptoms increase or are protective against violence in schizophrenia patients. Also, since self-help and recovery are gaining momentum within the arena of schizophrenia treatment, it would be of interest to know whether patients with OC symptoms derive any more or less benefit from peer support and recovery-based approaches to care.

Inevitably, given the paucity of scientific inquiry into patients with schizo-obsessive disorder, some chapters are more general and lack the support of a strong literature. For example, the chapter on treatments details the few available studies that focus directly on this topic and then concludes with an algorithm that—while intuitive—does not really derive from any robust literature. Similarly, the chapter on neurobiology is constrained in its interpretations by the relatively small base of studies, many of which emanate from the author and his collaborators. Thus, while the book by its title and substance espouses the notion that schizo-obsessive disorder might even represent a distinct neurobiological entity, it is fair to say that the jury is still out. As the author concludes, "Awareness of clinicians of the co-occurrence of obsessive-compulsive and schizophrenic phenomena is important for early identification and treatment." I concur with this well-stated synopsis, which goes on to declare, "This book is the first step toward that goal" (p 228). Given the content of this text, Dr Poyurovsky should be congratulated for pulling together the information and presenting it in such a readable style.

Peter F. Buckley, MD

[email protected]

Author affiliation: Medical College of Georgia, Augusta.

Potential conflicts of interest: Dr Buckley has been a consultant for the National Institute of Mental Health (NIMH) and has received grant/research support from NIMH, Ameritox, and Posit Science.

J Clin Psychiatry 2014;75(5):e466 (doi:10.4088/JCP.14bk09072).

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