Surprisingly, we found OCD symptoms to be more common than major depression, which is well-recognized and more fully studied in schizophrenia. By comparison, little attention has been given to OCD symptoms in schizophrenia. This may result from OCD symptoms being hidden. Obsessive Delusions Schizophrenia patients' OCD symptoms may become intertwined with their schizophrenic symptoms in a variety of ways. Such phenomena have undoubtedly contributed to the confusion surrounding this area.
Diagnostic convention maintains that obsessions and delusions are separate and apart.
Both obsessions and delusions rest on absurd or impossible ideas but these two symptoms are presumed to be different. Patients with obsessions should retain insight while in delusions the insight into the absurdity or impossibility of these ideas is supposedly lost. We found, however, that this tidy distinction commonly breaks down. Perhaps our patients have not read the official textbooks. But there are things a family can do to help the clinician understand and work with the patient.