Comorbid of Obsessive Compulsive Disorder and Schizophrenia: A Case Report

Abstract Introduction                 Schizophrenia was a chronic mental disorder that marked by abnormal social and impairment in reality testing ability. A person diagnosed with schizophrenia may experience amount of symptoms including hallucinations, delusions, and disorganized thinking, bizzare speech and behaviour. Obsessive compulsive disorder are well known as a comorbid of schizophrenia. Comorbid OCD will affect treatment of schizophrenia and others mental disorder. Case Presentation A 14-year-old student Muslim boy from a rural household in Central Java, Indonesia who had 8 years of formal education and live with his parent was brought to emergency department of mental hospital by his parents who reported a one year history of excessive washing of his body, soaking his body for hours in bathtub and sleep in bathroom. The patient first fell in January 2019; over a six-month period he became progressively deteriorated, lost interest in his hobby, stopped going to school and reduced his food intake. After one week treatment of venlafaxine and risperidone, He became more cooperative and interactive to the examiner. At that time, the patient reported delusional beliefs about contamination, paranoid delusion and there were several indications of formal thought disorder, including derailment, neologisms, concrete thinking, circumstantiality, and illogicality. An intelligence test revealed average intelligence (IQ=100). The total score of the Brief Psychiatric Rating Scale (BPRS) 3 dropped from 42 to 24, the score on the Yates-Brown Obsessive Compulsive Symptoms (YBOCS)4 scale dropped from 24 to 18, and the score on the Global Assessment of Functioning scale (GAF)5 increased from 25 to 55. After discharge the patient adhered to his medication regimen and at three months after discharge his clinical improvement persisted; he was able to maintain is his personal hygiene and take care of his daily needs, but he remained socially isolated and was unable to return to school.   Conclusion Obsessive compulsive disorder and schizophrenia could happen together in one individual. The treatment should consider underlying condition and cognitive function, especially if patient in productive age.