A new study conducted by Dr. Raymond Chan from the Institute of Psychology of the Chinese Academy of Sciences , together with his collaborators, examined patients with co-morbidity of schizophrenia (SCZ) and obsessive-compulsive disorder (OCD), a condition known as “schizo-obsession” (SOC), and showed that there were specific neural superimposed effects of combined schizophrenia and obsessive-compulsive symptoms at both white matter connectivity and resting-state functional connectivity comparing to patients with either schizophrenia or obsessive-compulsive disorders as well as healthy controls.

They also found a similar but attenuated pattern of altered connectivity in people with the co-occurrence of these two traits.

Traditionally SCZ and OCD have been considered as two distinct mental disorders. Recent evidence suggests that these two clinical groups may share a lot of similarities, including behavioural manifestations and cognitive impairments, including executive functions.However, previous research did not use a task-based functional MRI paradigm to directly investigate the neural mechanism of cognitive impairments in patients with SOC.

To bridge such a gap of knowledge, Ms. CHU Min-yi and Prof. YI Zheng-hui from Shanghai Mental Health Centre and Dr. Chan recruited 28 patients with SOC, 33 SCZ patients, 30 OCD patients, and 33 healthy controls to complete a task capturing shifting go/no-go performance inside the brain scanner. 

They found that patients with SCZ, OCD and SOC exhibited significantly lower shifting-related brain activation at the left postcentral gyrus, left paracentral lobule, left supplementary motor area, and right superior frontal gyrus. Patients with SOC also exhibited significantly lower brain activation than SCZ and OCD patients.

Moreover, OCD patients exhibited significantly greater brain activation at the left precuneus than SCZ patients and HCs while they were performing the stopping task. SOC and OCD patients also exhibited more brain activation than SCZ patients.

Together, these findings support a transdiagnostic framework of SCZ and OCD. Shifting-related brain activation reduction may be a biosignature shared across SCZ, OCD and SOC patients. Dr. Chan and his colleagues hope that these findings will finally guide us to develop a precision brain science approach for clinical diagnosis and intervention for psychosis spectrum disorders and OCD.

Ms. CHU Min-yi from Shanghai Mental Health Centre is the first author of this study, Prof. YI Zheng-hui from Shanghai Mental Health Centre, Drs. WANG Yi and Raymond Chan are co-corresponding authors. This work was supported by the National Natural Science Foundation of China Grant, Research Funds from Grant of Shanghai Mental health center, and the Philip K. H. Wong Foundation. .

The paper published in Schizophrenia Bulletin on Dec.23.

-          Chu MY, Li SB, Zhang Y, Wang LL, Lv QY, Lui SSY, Wang Z, Yi ZH*, Wang Y*, Chan RCK*. (2025). Cognitive inflexibility shares across schizophrenia and obsessive-compulsive disorder: A task-based functional MRI study. Schizophrenia Bulletin.