Evaluation of social cognition, empathy and quality of life in patients with obsessive compulsive disorder with and without schizophrenia

Evaluation of Social Cognition, Empathy and Quality of Life in Patients with Obsessive Compulsive Disorder with and without Schizophrenia Objectives: Obsessive-compulsive disorder (OCD) causes significant impairment in social activities and relationships. Obsessive compulsive (OC) symptoms and OCD prevalence are much higher in patients with schizophrenia compared to the general population. Social cognition refers to the mental processes underlying social interaction and recently it has become an important research target in OCD patients. Social cognition is a process that may contribute to impaired social functioning in OCD patients. Studies conducted to date have not compared the social cognition skills of OCD patients with and without schizophrenia. Our aim is to compare the social cognition and empathy levels of OCD patients with and without schizophrenia, and to evaluate the relationship between social cognition, empathy and quality of life with OC symptom severity and insight levels in these groups. Methods: 27 patients with OCD (OCD group), 22 patients with OCD and schizophrenia (OCD+schizophrenia group) and 27 healthy individuals (control group) were included in our study. The patients were interviewed in two sessions. In the first session, patients were examined with the Structured Clinical Interview for DSM-5, Clinician Version (SCID-5/CV) for definitive diagnoses, and the Yale-Brown Obsession and Compulsion Scale, Hamilton Depression Scale, Hamilton Anxiety Scale, and Brown Assessment of Beliefs Scale (BABS) were applied. In the second session, Dokuz Eylül Theory of Mind Index (DEToMI) and Reading Mind in the Eyes Test (RMET), which evaluate social cognition, were applied. Then, they were asked to complete the self-report Empathy Quotient and the World Health Organization Quality of Life-BREF Scale. Results: There was no difference between the OCD+schizophrenia group and the OCD group in terms of OC symptom severity, depression and anxiety severity, and quality of life. In terms of insight for OC symptoms, the BABS scores of the OCD+schizophrenia group were found to be significantly higher than the OCD group. DEToMI and RMET scale scores of patients and healthy subjects were compared. In DEToMI total and RMET total scores, the control group scored higher than both patient groups, and the OCD group scored higher than the OCD+schizophrenia group. A correlation was found in the OCD group, between the increase in OC symptom severity and the decrease in DEToMI empathetic understanding subscale scores. Another correlation was found in the OCD+schizophrenia group, between the increase in OC symptom severity and the decrease in DEToMI metaphor comprehension subscale scores. Conclusions: Social cognition skills are better in the control group than both groups, and it is better in the OCD group than in the OCD+schizophrenia group. It was determined that social cognition was associated with OC symptom severity, anxiety and depression levels, insight levels and quality of life. Our study is the first to evaluate OCD patients and OCD patients with schizophrenia by comparing them with healthy controls in terms of social cognition, and showed that when OCD patients are diagnosed with schizophrenia, social cognition is impaired more than OCD patients without schizophrenia comorbidity, and the quality of life does not change.