The issue of differential diagnosis of obsessive-compulsive disorder and schizophrenia

Abstract

The data of medical records of patients who applied for a consultation at the Novgorod clinical specialized center of psychotherapy were analyzed. It is found that in clinical practice, it is difficult to differentiate schizophrenia and obsessive-compulsive disorder in some cases, since the patient may have both ego-syntonic and ego-dystonic thoughts. Clinical symptoms of obsessivecompulsive disorder may be the first signs of schizophrenia, the diagnosis of which becomes clearer over time. Clinical symptoms of obsessive-compulsive disorder were differentiated from those of schizophrenia, taking into account the common genetic loci in affective disorder and schizophrenia. The pathogenetic and pathophysiological mechanisms of the formation of obsessive-compulsive symptoms are discussed. Various therapeutic strategies are analyzed, which take into account the approach with the reduction of emotions due to the circumstances that cause them, or due to the direct influence on emotions. In the first case, psychotherapeutic measures are used, and in the second, pharmacotherapy, which served as the main hypothesis in the formation of a comprehensive method of rehabilitation based on rational pharmacotherapy, acting on a significant emotion.