Thirty schizophrenic patients who had obsessional symptoms at some time in their lives were investigated. They formed 3.5 per cent of the total schizophrenic in-patient population of the London postgraduate teaching hospital for psychiatry during a four-year period.
In twelve cases the obsessional symptoms had made their first appearance before the age of twenty, and in eleven before the age of thirty-five.
None of these patients had received psychiatric attention before the onset of their schizophrenic symptoms although in a considerable proportion obsessional symptoms had been present years previously.
In six cases, depression had been the first presenting symptom, while in eight cases obsessional symptoms had preceded any other by a considerable time.
In twenty-six of the thirty patients, the schizophrenic condition was of the paranoid type.There was no case of catatonic schizophrenia among this group.
The fate of the obsessional symptoms after the onset of the schizophrenia was studied. Transition of obsessional ideas into delusions was observed in six cases.
The duration, elaboration and variety of obsessional symptoms appeared to be inversely correlated with the severity of the schizophrenic illness.
Symptoms of depression were observed in twenty-five of the thirty schizophrenic patients.
There was a marked tendency to remissions in the majority of patients of this series and a conspicuous absence of malignant schizophrenic developments leading to disintegration of the personality.
The response to various treatments employed in this group was unimpressive.
↵* Thesis for the degree of M.D. submitted to the University of Witwatersrand in 1954 (abridged).