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Abstract Obsessions and compulsions are not new symptoms to schizophrenia, or psychotic symptoms are new to OCD. The Aim: A step towards illumination and further understanding of the presence of obsessive compulsive symptoms in schizophrenia as a process.Objectives: 1)To detect the frequency of comorbid obsessivecompulsive symptoms in schizophrenic patients 2) To recognize the clinical difference between the schizophrenic patient with or without obsessivecompulsive symptoms.3) To detect if there is possible underlying structural and functional differences between the schizophrenic patients with or without obsessivecompulsive disorder symptoms.4)To find the prognostic impact of the presence of obsessivecompulsive symptoms on the schizophrenic process.Subjects and methods: Subjects: All patients coming to psychiatric department out patient clinic in Mansoura University Hospital for 3 months duration were screened for schizophrenia (143 patients). A further subclassification was done according to presence or absence of obsessivecompulsive symptoms (32 patients). Methods: Preliminary assessment:A) A semistructural interview (including: Detailed history taking B) Psychiatric rating studies including: YaleBrown Obsessive compulsive Scale, YaleBrown Obsessive compulsive Scale symptoms checklist, Positive and Negative Syndrome Scale (PANSS), Personality assessment form (PAF), Global Assessment of functioning (GAF) and WHO (five) well being index. C)Neuroimaging study: including: i) Caudate nucleus volume ii)Magnetic resonance spectroscopy for metabolites in the caudate nucleus.Follow up assessment: both groups of patients (with or without OCS) received treatment for 6 months then, they were reassessed again using:(psychiatric rating scales) Results: and conclusions: 1) The frequency of OCS in schizophrenic patients was 22.38%, 2) The sociodemographic finding concluded that OC schizophrenic patients were more likely to live alone, with poorer occupational functioning even that they were of higher education level than schizophrenic patients without OCS. 3) Follow up study concluded that the presence of OCS in schizophrenia is a strong predictor for poorer prognosis of schizophrenia. 4)Caudate volume was found to be reduced in either schizophrenic patients with or without OCS. 5)Functional magnetic resonance spectroscopy found that the schizophrenic patients without OCS have significant increase in choline conc. and with average Nacetyl aspartate conc. On the other hand, schizophrenic patients with OCS have significant reduction in Nacetyl aspartate conc. with average choline conc |