Characterizing executive dysfunctions in patients with schizo-obsessive comorbidity: comparing schizophrenia with obsessive-compulsive disorder

Clinical Snapshot

Key Findings

• P Value: Not reported in abstract

• Effect Size: Not reported in abstract

• Primary Outcome: Executive function component profiles distinguishing schizo-obsessive comorbidity from schizophrenia and OCD

• Nnt Or Sensitivity: Machine learning classification achieved 'acceptable performance' for SOC vs OCD but 'lower performance' for SOC vs SCZ

• Confidence Interval: Not reported in abstract

Clinical Application

Neuropsychological assessment battery feasible in specialist mental health services with trained psychologists Relevant to Australian mental health services. Executive function assessment could inform treatment planning and cognitive rehabilitation approaches under Medicare-funded psychology services Adults with schizophrenia, OCD, or comorbid presentations in psychiatric and neuropsychological settings

Abstract

BACKGROUND: The term 'schizo-obsessive comorbidity (SOC)' is used to describe the presence of obsessive-compulsive symptoms or obsessive-compulsive disorder (OCD) in patients with schizophrenia (SOC). Recent studies have found overlapped executive dysfunctions in SCZ and OCD implicating shared pathophysiology. However, specific deficits in the components of executive function (EF) in patients with SOC remains unclear. METHODS: We recruited 37 patients with SOC, 68 patients with SCZ, 70 patients with OCD, and 59 healthy controls (HCs). All participants completed a battery of measures for EF components, namely initiation, sustained attention, online updating, switching, disinhibition, and planning. Apart from traditional group-mean analysis, we applied machine learning approaches to identify the unique patterns of EF among different clinical groups. RESULTS: The results showed that the three clinical groups could be distinguished from HCs. The feature importance analysis showed that, to classify clinical groups from HC, online updating was the core feature of SCZ patients, whereas disinhibition and online updating jointly determine classification between OCD patients and HC. In differentiating SOC from HC, online updating, planning, and disinhibition collectively served as key features. Machine learning algorithms classified SOC and OCD with acceptable performance but classified SOC and SCZ with lower performance. CONCLUSIONS: Deficits of EF are shared features among patients with SOC, SCZ, and OCD. However, the specific components of executive dysfunction in these clinical groups appeared distinct.

References

1. 1.Chu, M. Y., Zhu, N. J., Li, S. B., Wang, Y., Yi, Z. H., Zhang, Y., Lv, Q. Y., Lui, S. S. Y., Wang, Z., & Chan, R. C. K. (2026). Characterizing executive dysfunctions in patients with schizo-obsessive comorbidity: comparing schizophrenia with obsessive-compulsive disorder. Psychological Medicine. https://doi.org/10.1017/S0033291726104061