Schizophrenia can manifest itself in different ways. It has many forms, which are similar in its symptoms to other mental disorders and neuroses. So, pseudoneurotic schizophrenia strongly resembles obsessive-compulsive disorder. There is a connection between them, but still, they are two different diseases. Learn the difference between OCD and schizophrenia. To do this, consider their features.
General features of OCD
OCD is an obsessive-compulsive disorder. It consists of obsessions – obsessive thoughts that periodically force a person to perform certain actions – compulsions. With their help, the body relieves itself of stress and gets rid of anxiety.
A typical example of OCD is the desire for perfect cleanliness and the fear of infection. To rid himself of fear, a person constantly washes his hands, rarely touches objects, does not shake hands with other people, etc.
At the same time, there are usually no real reasons to be afraid. It’s just that obsessive thoughts do not give the patient peace until he performs a certain ritual – he will wash his hands, turn off all appliances when leaving the house, check several times whether the front door is closed, etc. A person performs all these actions spontaneously. Sometimes it comes to the point that he tears his hands into blood, trying to wash them from non-existent dirt.
Obsessive-compulsive disorder is included in the ICD-10 in section F42. According to this classification, the disorder is characterized by obsessive thoughts and stereotyped actions. They are perceived as their own, and not imposed, which happens with schizophrenia when a person does or says supposedly under the influence of external forces.
With OCD, the patient understands that obsessive thoughts and actions prevent him from living, turning into a chronic one, but he cannot help himself. The level of anxiety is so high that the only way to get rid of it is through rituals.
People with OCD have serotonin dysfunction. Serotonin is one of the neurotransmitters in the brain. It performs various functions, one of which is to bring joy. It is also called the “feel-good hormone”. In violation of the production of serotonin, the process of transmission of impulses between the neurons of the brain worsens. This occurs due to pathological changes in the following departments:
- Basal ganglia;
- Caudate nucleus;
- Frontal part of the cortex.
In turn, these changes can be triggered by the following factors:
- Genetic predisposition. Specific genes are responsible for the production and distribution of serotonin. If they mutate, the risk of developing OCD increases.
- Autoimmune causes. Infections can lead to the disorder, most often group A streptococcal infections, such as tonsillitis or scarlet fever.
- Acquired. First of all, we are talking about injuries, including birth injuries, as well as defects associated with injury.
- Perfectionism. This character trait, which is the pursuit of perfection, can lead to obsessions associated with cleanliness and order. Perfectionism itself is often the result of excessive demands placed on the child by parents.
In a person with OCD, the brain is constantly in an excited state. He does not receive signals that would force him to calm down or enjoy. To relax a little, you have to perform rituals.
The main symptoms of OCD are obsessive thoughts and stereotyped actions. The following symptoms are also observed:
- Weakness, fatigue;
- Various kinds of pain;
- Memory impairment;
- Violation of logical thinking;
- Aggression or, conversely, apathy;
- Problems with personal hygiene;
- Visions and voices.
With OCD, the patient’s mood often changes. He can be funny or sad. Sometimes he considers himself the chosen one, which voices and visions often try to convince him of.
The disorder can appear at any age and with the same probability in both men and women.
If a person experiences an irresistible desire to constantly wash his hands or arrange objects in certain places, clearly observing symmetry, he must be shown to a psychotherapist. Gradually, the number of obsessions and compulsions, and hence the rituals, will increase.
Patients with OCD exhibit unusual behavioral patterns. They are not specific and cannot be diagnosed, however, experts note that obsessive-compulsive disorder is typical for people with such traits:
- Responsibility for the execution of tasks. They clearly follow the rules and regulations, and often they come up with them themselves, and after that, they can no longer refuse them.
- Demanding. This is especially true for leaders. They not only follow the rules themselves, but also require their strict observance by their subordinates. The problem is that many people simply consider such orders meaningless and are not ready to tolerate such treatment.
- Superstition. People with OCD are very superstitious and believe in all sorts of superstitions. Usually the rituals invented by them are connected precisely with superstitions.
Often a person gets bored with rituals, as a result of which he tries to get rid of them. However, anxiety prevents him from doing so. Some believe that over time everything will pass on its own. However, in most cases, the condition worsens, and the symptoms of the disorder expand. As a result, it can develop into a long-term neurosis.
One of the hallmarks of OCD is resistance to therapy.
As can be seen, some of the symptoms, such as voices, visions, and intrusive thoughts, resemble those of schizophrenia, especially pseudoneurotic.
However, they have much more differences. An experienced specialist will never confuse these two disorders. Let us consider in more detail schizo-neurosis or neurosis-like schizophrenia.
General features of schizoneurosis
Pseudoneurotic schizophrenia is partially similar to sluggish, but in general, it is dominated by neurotic symptoms. As for the typical symptoms of most forms of schizophrenic disorder, that is, delusions and hallucinations, they are usually absent in schizoneuroses. If the patient is not treated, then subsequently the signs become more and more, and eventually, psychopathology is diagnosed.
Specific causes of pseudoneurotic schizophrenia are almost impossible to identify. However, risk factors are known, including:
- Genetic mutations;
- Dysfunction of neurotransmitters;
- Psychomotor disorders;
- Uncomfortable social conditions;
- Psychological trauma.
The onset of the disorder usually occurs at a young age. As a rule, it is detected in adolescent boys. However, the risk of getting sick remains in adulthood, both in men and women.
Differences from Neurosis
Symptoms of neurotic schizophrenia are similar to signs of neurosis. The following criteria allow to differentiate the diagnosis:
- Neurosis occurs after a strong psycho-emotional shock or as a result of prolonged stress. Schizophrenia can develop for no apparent reason.
- Neurotics are aware of the disease, they understand that they need to seek help. Schizophrenics do not see oddities in their behavior. As a rule, relatives bring them to the reception.
- -Neurosis causes great inconvenience in personal life and work, but it does not affect the sense of personality. Schizophrenia, even if it is sluggish, leaves an imprint on personal qualities, often leading to their complete disintegration.
- Neurosis is successfully treated, and completely. Pseudoneurotic schizophrenia responds well to treatment, but the diagnosis remains forever. A person throughout his life will have to take medication and engage in prevention.
We now turn to the specific symptoms of neurosis-like schizophrenia. Some of them are included in the symptoms of OCD.
Symptoms of the disease appear suddenly. Moreover, there can be a lot of them, depending on each specific case. They are divided into several groups: Behavioral, Psycho-emotional, Sensorimotor, and cognitive. We list the most common.
- Obsessions of high strength. A person performs rituals for a long time, not paying attention to comments from the outside. Some patients wash their hands 3-5 times just before leaving the house, others count up to a certain number before opening the door, etc.
- Alienation. The patient withdraws from society and communicates less with people, including with relatives. At the same time, communication occurs more out of need than because of the desire of the patient.
- Change in the manner of speech. Strange abstract phrases appear in the lexicon of a person, understandable only to him.
- Atypical clothing style. It is often just untidy, but can also be frilly or overly flashy.
- Decreased interest. Even what used to be of great interest to a person causes indifference in him.
- Refusal of food. Sometimes it comes to anorexia. At the same time, the motives for losing weight are incomprehensible, since they are not associated with harmony and beauty.
- Suicide attempts. There are extreme cases when a person cannot cope with his emotions and anxiety.
- Mood swings for no reason;
- Constant anxiety;
- Tendency to reflection;
- Several different emotions in one situation;
- Anhedonia (inability to have pleasure);
- Strange phobias (fear of the letter “K”, color, sound, etc.);
- Suicidal moods.
- Depersonalization – a feeling of loss of one’s own “I”, loss of personality.
- Dysmorphomania is the belief in the presence of defects or shortcomings in appearance, in one’s own ugliness.
All this leads to the fact that the patient stops communicating with people. He begins to wear clothes that cover most of the body, he may even sign up for plastic surgery. Many patients are prone to anorexia and bulimia.
- Poor concentration of attention;
- Fine line between real and fictional;
- Violation of logical thinking;
- Decrease in the level of intelligence.
A patient with neurosis-like schizophrenia may not have all of these symptoms. However, just a few of them are enough to seek help from doctors.
Examples – The most common symptom of pseudoneurotic schizophrenia is phobias. At the same time, patients are afraid of completely insignificant things, and sometimes pretentious ones. Sometimes they are afraid of the fact that they can be afraid of something. In clinical practice, there are cases when patients were afraid to put on glasses because they could transfer them to a different reality.
Most often, those with such schizophrenia, they are afraid of open spaces and diseases. However, it happens that a person is simply afraid to die if he does not count to ten. Gradually, fears become more and more, and they begin to control his life. The patient loses control over his actions.
Another symptom is obsessions that develop along with fears. It is because of them that this form of schizophrenia is often confused with OCD. The schizophrenic constantly perform some kind of ritual: walks around the chair several times before sitting down, forces the mother to touch the leg of the chair, goes to bed in a hat and one sock, etc.
Often schizophrenics of this type look for flaws in themselves that are not really there. The problem is that such crazy ideas can lead to self-torture, including through various diets. There is a risk of organ damage. Then the somatic will join the mental illness.
There are also patients with an obsession with a shopaholic. At the same time, a person is ready to spend all the money and will not even worry about it. With OCD, the patient can also become a spender, but he realizes that he is acting irrationally and is ready to accept help from doctors.
Differences OCD and Schizophrenia
OCD differs from schizophrenia in many ways. The doctor will never confuse these two disorders. The common symptom is obsessions and compulsions. However, with neurosis, a person tries to overcome them, or at least hide them. The schizophrenic does not do this, because he believes that everything is going well with him.
Neurotics retain common sense. They are aware of their actions, even if they are performed automatically, that is, in the format of compulsions. But at the same time, they understand that such a state is not normal. Moreover, they try to behave correctly. Only in severe cases, the control completely disappears.
In schizophrenics, mental functions are split. They are not critical to their condition. They may act provocatively or strangely, but they do not understand that they cause shock in others. In other words, people with this form of schizophrenia perceive themselves as healthy.
Hallucinations in neurosis also occur, but they are short-term and appear mainly before bedtime, when the brain is tired, and after waking up, when brain activity is not as active as during the day. The OCD patient realizes that the cause of the hallucinations is his illness.
In schizophrenia, voices and visions are spontaneous and may be chronic. Delusions and hallucinations are capable of transferring a person’s consciousness to another reality.
The main difference between OCD and schizophrenia is that the former does not cause personality damage. A person can completely get rid of the disorder without a trace for his consciousness. Schizophrenia leaves a defect, it is reflected in the “I” of a person. In severe cases, complete disintegration of the personality occurs.
Treatment of OCD and Schizophrenia
OCD is treated with psychotherapy. To stop the symptoms, that is, anxiety, mild sedatives may be prescribed. Antidepressants are used only as a last resort. After the elimination of the factor that provoked the disorder, and the main symptoms, the patient returns to normal life. Even with an unfavorable outcome, OCD cannot turn into schizophrenia, since these are two diseases of different origin. One is neurosis and the other is psychopathology. Schizophrenia requires long-term treatment. Moreover, it continues throughout life, even if the symptoms no longer bother. This does not mean that you will have to lie in the hospital and drink medicines until your death, but you will need to be observed by a psychotherapist and psychologist systematically.