Cognitive deficits have been shown to be one of the most robust predictors of functional outcome in schizophrenia patients and it has been assumed that burden due to comorbid psychopathology such as OCS might increase cognitive deficits in an additive manner. Cognitive deficits are commonly present in people with schizophrenia as well as in people in an at risk mental state for psychosis. In recent years, several reports evaluated the association between OCS and cognitive impairments in patients with psychotic disorders. There is evidence that patients with comorbid OCS experience more severe psychotic and depressive symptoms, have increased rates of hospitalization and suicide attempts, and experience greater social and occupational impairments compared to schizophrenia patients without OCS. Life-time prevalence of OCS and OCD in people with schizophrenia are, respectively, 31% and 12%, with symptoms already being present in the at risk mental state (13% and 5%) and during the first episode of psychosis (17% and 7%), but with increasing prevalence in the later stages of disease. Amongst common comorbidities are obsessive–compulsive symptoms (OCS) and obsessive–compulsive disorder (OCD). However, large heterogeneity between studies highlights the complex nature of factors influencing cognition in people with psychotic disorder and comorbid OCS and warrants further research into possible moderating factors.Ĭomorbidities, such as depression, substance abuse and anxiety disorders, are highly prevalent in psychotic disorders. Overall, comorbid OCS were not associated with cognitive impairment. Patients fulfilling the criteria for an obsessive–compulsive disorder showed less impairment in cognitive inhibition compared to the OCS + group ( R 2 = 0.63). Meta-regression revealed advanced age was significantly correlated with worse performance of the OCS + group in processing speed ( R 2 = 0.7), working memory ( R 2 = 0.11), cognitive inhibition ( R 2 = 0.59), and cognitive flexibility ( R 2 = 0.34). Post-hoc analyses of processing speed tasks not purely based on reaction-time showed worse performance in the OCS + group with a small effect size (SMD = − 0.190 p = 0.029). We predominantly found large heterogeneity in effect size and direction among studies. No overall associations between OCS + and OCS− in any of the 17 investigated cognitive domains were found. We used meta-regression to assess possible confounding effects. We conducted meta-analyses on several cognitive domains to investigate overall group differences between patients with a psychotic disorder and co-occurring OCS (OCS +) and those without OCS (OCS−).

Obsessive–compulsive symptoms (OCS) in psychotic disorders are associated with unfavorable outcomes, whether this extends to cognitive function remains unclear.

Meta psychotic