Imipramine in the Treatment of Obsessive-Compulsive Symptoms in Schizophrenic Spectrum Illnesses: Three Case Reports

It has long been known that obsessions and compulsions occur during the course of a schizophrenic illness (1- 7). It is, therefore, of interest that there has been little systematic research into the treatment of these symptoms in patients suffering from schizophrenia. It is possible that the meager research in this area is related both to the difficulty at times in differentiating signs of a psychotic decompensation in severe obsessive-compulsive disorder (OeD) from those of schizophrenia; and to the significant amount of controversy regarding the function of obsessive compulsive symptoms in patients suffering from schizophrenia and related diseases. For example, Sullivan (3) was one of the first to note a relationship between schizophrenia and obsessive compulsive disorder, and maintained that these conditions can shift from one to the other. Over 30 years ago, Rosen (4) studied 30 obsessive sch izophrenics and observed that the obsessions emerged either prior to, or concomitant with, the schizophrenic symptoms, and that none of the patients had received psychiatric treatment prior to the schizophrenic decompensation . The implication is that obsessions were not taken as seriously as the psychotic symptoms even though they had presaged serious illness. This is identical to one of the cases we will present