Observational studyThe British journal of psychiatry : the journal of mental science2024
The role of psychosis and clozapine load in excessive checking in treatment-resistant schizophrenia: longitudinal observational study.
Observational study in The British journal of psychiatry : the journal of mental science, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 3 citations in OpenAlex.
- Unexpected resolution of clozapine-induced obsessive-compulsive symptoms with cariprazine augmentation: a case report.BMC psychiatry · 2026Article
- Clozapine-induced obsessive-compulsive symptoms in schizophrenia: Clinical and cognitive determinants of dysfunctional checking.Psychological medicine · 2025Article
- Prevalence of obsessive-compulsive symptoms in patients with schizophrenia treated with clozapine: a scoping review.BMC psychiatry · 2025Article
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Authors and funding
15 authors at 8 institutions in 3 countries.
Funding
Abstract
backgroundA significant proportion of people with clozapine-treated schizophrenia develop 'checking' compulsions, a phenomenon yet to be understood.
aimsTo use habit formation models developed in cognitive neuroscience to investigate the dynamic interplay between psychosis, clozapine dose and obsessive-compulsive symptoms (OCS).
methodUsing the anonymised electronic records of a cohort of clozapine-treated patients, including longitudinal assessments of OCS and psychosis, we performed longitudinal multi-level mediation and multi-level moderation analyses to explore associations of psychosis with obsessiveness and excessive checking. Classic bivariate correlation tests were used to assess clozapine load and checking compulsions. The influence of specific genetic variants was tested in a subsample.
resultsA total of 196 clozapine-treated individuals and 459 face-to-face assessments were included. We found significant OCS to be common (37.9%), with checking being the most prevalent symptom. In mediation models, psychosis severity mediated checking behaviour indirectly by inducing obsessions (
conclusionsWe elucidated different phases of the complex interplay of psychosis and compulsions, which may inform clinicians' therapeutic decisions.
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