Obsessive-compulsive symptoms moderates the effects of cognitive functioning on quality of life in clozapine-treated schizophrenia

Obsessive-compulsive symptoms (OCS) are frequently reported in clozapine-treated schizophrenia. Studies on the effects of OCS on cognitive abilities and quality of life (QoL) yielded contrasting results, ranging from benefits to adverse effects. We investigated the interactive effects of OCS and cognitive functioning on different aspects of QoL in clozapine-treated patients. 54 patients with schizophrenia underwent a neurocognitive, functional and psychopathological battery. Using moderation models, we examined the interplay between OCS and cognitive abilities on different QoL domains. We found several main effects and interactions between I.Q. and OCS on global QoL, as well as specific effects on psychological and environmental domains. Mild OCS have beneficial effects on QoL, but, as OCS become more severe in patients with more preserved cognitive abilities, the QoL drops steeply. Findings highlight the complex interplay between OCS and cognitive functioning, whose effects on QoL appear to depend on patients’ OCS severity and cognitive profile, as well as on the functional domain addressed. Our data may help to reconcile the seemingly contrasting results from previous studies, and shed a new light on the importance of evaluating OCS in schizophrenia, thus establishing specific interventions that can lead to consequent effects on social well-being and QoL.