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The “Obsessive Paradox”

The Complex Relationship Between Cognitive and Obsessive Dimensions in Schizophrenia

Tonna, Matteo, MD*; Ottoni, Rebecca, MD; Pellegrini, Clara, MD; Bettini, Elena, MD; Accardi, Valeria, MD; Ossola, Paolo, MD; De Panfilis, Chiara, MD; Marchesi, Carlo, MD

The Journal of Nervous and Mental Disease: January 31, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/NMD.0000000000000932
Original Article: PDF Only

The objective of the study was to investigate the relationship between cognitive functions and obsessive-compulsive dimension in schizophrenia and a possible moderating effect of schizophrenia symptom dimensions on this association. Sixty-one schizophrenia patients were administered the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and the Matrics Consensus Cognitive Battery. A U-shaped curve described a gradual transition from an inverse association to a positive relationship between YBOCS and processing speed scores, along a severity gradient of obsessive dimension. This effect (“the obsessive paradox”) was not moderated by other symptom dimensions. The present study suggests that severe obsessive-compulsive symptoms may participate to counterbalance processing speed impairment independently from other symptom dimensions. These results highlight the complexity of the relationship between cognitive and obsessive dimensions in schizophrenia.

*Department of Mental Health, Local Health Service; and

Department of Neuroscience, Psychiatric Unit, University of Parma, Parma, Italy.

Send reprint requests to Matteo Tonna, MD, Department of Neuroscience, Psychiatric Unit, University of Parma, University Hospital, Braga Bldg, Viale A. Gramsci N 14, 43126 Parma, Italy. E-mail:

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