Dr. Nagi is a PGY-5 child and adolescent psychiatry fellow, and Dr. Somvanshi is a PGY-1 psychiatry resident, Department of Psychiatry, Columbia University College of Physicians and Surgeons, Harlem Hospital Center, New York, New York. Dr. Reliford is Director and Chief of Service, Department of Child and Adolescent Psychiatry, Columbia University College of Physicians and Surgeons, Harlem Hospital Center, New York, New York.
Disclosures The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
After 12 months of combined CBT and fluoxetine, M’s global assessment of functioning (GAF) scale score improves from 35 to 80, indicating major improvement in overall functional level.
Acknowledgement
The authors thank Uzoma Osuchukwu, MD, ex-fellow, Department of Child and Adolescent Psychiatry, Columbia University College of Physicians and Surgeons, Harlem Hospital Center, New York, New York, for his assistance with this article.
Bottom Line
Obsessive-compulsive disorder may masquerade as a schizophrenia spectrum disorder, particularly in younger patients. Accurate differentiation is crucial because antipsychotics can induce de novo obsessive-compulsive symptoms (OCS) or exacerbate preexisting OCS, and selective serotonin reuptake inhibitors may exacerbate psychosis in schizo-obsessive patients with a history of impulsivity and aggressiveness.
Related Resource
Raveendranathan D, Shiva L, Sharma E, et al. Obsessive compulsive disorder masquerading as psychosis. Indian J Psychol Med. 2012;34(2):179-180.
