| Sumario: | Objective: To determine the prevalence of obsessive--compulsive symptoms and obsessive--compulsive disorder in patients with schizophrenia or related disorders or subjects at ultra high risk for development of psychosis. Secondly, to determine the time of occurrence of obsessive--compulsive symptoms related to the onset of first psychosis. Method: We collected data on all patients who were referred consecutively to our specialized clinic for first episode psychosis patients and ultra high risk subjects in Amsterdam between 1 July 2006 and 1 July 2008. Diagnosis of psychotic disorders was established using the Comprehensive Assessment of Symptoms and History schedule. Obsessions and compulsions were defined in accordance with DSM-III-R criteria and assessed by clinicians. We analyzed the onset of obsessive--compulsive symptoms and its relation to the onset of first episode psychosis. Results: When a strict definition of obsessive--compulsive symptoms is used, 9.3% (n == 18) of patients with schizophrenia or a related disorder exhibited obsessive--compulsive symptoms and 1.5% also met criteria for obsessive--compulsive disorder. The onset of obsessive--compulsive symptoms occurred before, concurrent with and after onset of first episode psychosis in the following proportion of patients: 7/18, 3/18, 8/18. We found a prevalence of 20.7% of obsessive--compulsive symptoms in ultra high risk subjects. Conclusion: Using a strict definition of obsessive--compulsive symptoms, we found relatively low prevalence rates of obsessive--compulsive symptoms and obsessive--compulsive disorder in patients with schizophrenia or related disorders; the rates are even lower than known rates of obsessive--compulsive symptoms and obsessive--compulsive disorder in the general population. Obsessive--compulsive symptoms rates in ultra high risk subjects are comparable to those in the general population. Further investigation of the predictive validity of obsessive--compulsive symptoms in ultra high risk subjects for developing psychosis is needed. Obsessive--compulsive symptoms either develop prior, during or after the onset of first episode psychosis.
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