Obsessive compulsive symptoms, social functioning and executive functions in chronic schizophrenia

Introduction Schizophrenia leads to functional deficits. A third of schizophrenia patients have obsessive compulsive symptoms (OCSs). The existing studies, which have investigated the effect of OCSs on social functioning (SF) of schizophrenia patients have produced contradictory findings and, interestingly, they have not adjusted for the role of executive functioning. Objectives To investigate the predictive role of OCSs on SF in schizophrenia controlling for the effects of executive functioning. Methods In a cross-sectional study of 110 chronic schizophrenia patients we assessed OCSs (Yale-Brown Scale), SF (Strauss Carpenter Scale) and composite executive function (cognitive flexibility: Intra–extra dimensional set shifting task and planning: Stockings of Cambridge task) using the Cambridge Neuropsychological Test Automated Battery (CANTAB). We also measured total symptoms (PANSS total scores) and illness duration. Regression analysis tested the predicting role of OCSs (YBOCS total score) on functioning taking into account executive function (composite score) duration of illness and schizophrenia symptoms. Results OCSs were associated with better SF (B = 0.099; 95% CI = 0.019, 0.180; t  = 2.449; df = 88; P  = 0.016). This result was driven by the association of OCSs with job functioning (B = 0.043; 95% CI = 0.006, 0.081; t  = 2.289; df = 88; P  = 0.024). Executive functions were not significantly associated with social functioning. Conclusions OCSs and not executive functions are associated with social functioning in schizophrenia. Future studies should examine whether OCSs represent a compensatory mechanism aiming at preserving social functioning in the disorder.