How Is OCD Different From Schizophrenia: Main Symptoms and Differences

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Schizophrenia can manifest itself in different ways. It has many forms that are similar in their symptoms to other mental disorders and neuroses. For example, pseudoneurotic schizophrenia strongly resembles obsessive-compulsive disorder. There is a connection between the two, but they are still two different diseases. Let’s find out the difference between OCD and schizophrenia. To do this, let’s look at their features.

General Features of OCD

OCD is an obsessive-compulsive disorder. It consists of obsessions – compulsive 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 fear of getting infected. To get rid of the fear, a person constantly washes his hands, rarely touches objects, doesn’t shake other people’s hands, etc.

In this case, there is usually no real reason to be afraid. Obsessive thoughts just don’t give the patient peace until he or she does a certain ritual, such as washing his or her hands, looking for a number of rounds at for a particular number of times, turning off all appliances, leaving the house, checking several times whether the front door is closed, and so on. The person performs all of these actions spontaneously. Sometimes it comes to the point where the person tears his or her hands up into blood, trying to wash them of non-existent dirt.

The disorder is characterized by obsessive thoughts and stereotypical actions. They are perceived as one’s own and not imposed, which is the case with schizophrenia, when a person does or speaks as if under the influence of external forces.

With OCD, the patient realizes that the intrusive thoughts and actions are disturbing his life, becoming chronic, but cannot do anything about it. The level of anxiety is so high that it is possible to get rid of it only by committing rituals.


People with OCD have serotonin dysfunction. Serotonin is one of the brain’s neurotransmitters. It has various functions, one of which is to bring joy. It is also called the “good mood hormone.” Impaired production of serotonin impairs the transmission of impulses between neurons of the brain. This occurs due to pathological changes in the following departments:

  • Basal ganglia.
  • The amygdala body.
  • Caudate nucleus.
  • Frontal cortex.

In turn, these changes can be provoked by the following factors:

  • Genetic predisposition. Specific genes are responsible for the production and distribution of serotonin. If their mutation occurs, the risk of developing OCD increases.
  • Autoimmune causes. Infections, most often group A streptococcal, such as tonsillitis or scarlatina, can lead to the disorder.
  • Acquired. First, we are talking about trauma, including birth trauma, as well as defects associated with trauma.
  • Perfectionism. This trait of character, which is the striving for perfection, can lead to obsessions with cleanliness and order. Perfectionism itself is often the result of exaggerated demands placed on the child by the parents.

In a person with OCD, the brain is in a constant state of agitation. He doesn’t get the signals that would force him to calm down or enjoy himself. To relax a little, one has to perform rituals.


The main symptoms of OCD are obsessive thoughts and stereotypical actions. The following signs are also observed:

  • Weakness, rapid fatigue.
  • Insomnia.
  • All kinds of painful feelings.
  • Impaired memory.
  • Impaired logical thinking.
  • Aggression or, on the contrary, apathy.
  • Problems with personal hygiene.
  • Visions and voices.

When suffering from OCD, the patient’s mood changes frequently. He may be cheerful or sad. Sometimes he or she considers oneself the chosen one and is often persuaded by voices and visions.

The disorder can appear at any age and is equally likely to occur in both men and women.

If a person experiences an irresistible urge to constantly wash their hands or arrange objects in certain places, clearly observing the symmetry, it must be shown to a psychotherapist. Gradually, the number of obsessions and compulsions, and consequently of rituals, will increase.

Behavioral Features

Patients with OCD exhibit unusual behavioral features. They are not specific and cannot be used to make a diagnosis, but experts note that obsessive-compulsive disorder is characteristic of people with these traits:

  • Task responsibility. They clearly follow the rules and regulations, and often make them up for themselves, and then cannot refuse them.
  • Demanding. This is especially true for managers. They not only follow the rules themselves, but also require strict compliance from their subordinates. The problem is that many people simply consider such orders senseless and are not ready to tolerate such an attitude.
  • Superstition. People with OCD are very superstitious and believe in all kinds of omens. Usually the rituals they devise are related specifically to superstition.

Often the person is bored with rituals, and as a result, he tries to get rid of them. However, anxiety prevents him from doing this. Some believe that with time, everything will pass on its own. However, in most cases, the condition worsens, and the symptomatology of the disorder expands. It can eventually develop into a long-term neurosis.

One of the hallmarks of OCD is resistance to therapy.

As you can see, some of the symptoms, such as voices, visions and intrusive thoughts, resemble the signs of schizophrenia, especially pseudoneurotic.

However, there are many more differences. An experienced professional will never confuse the two disorders. Let’s take a closer look at schizoneurosis, or neurosis-like schizophrenia.

General Features of Schizo Neurosis

Pseudoneurotic schizophrenia is partially similar to flaccid schizophrenia, but it is generally dominated by neurotic symptoms. As for the symptoms typical of most forms of schizophrenic disorder, that is, delusions and hallucinations, they are usually absent in schizo neurosis. If the patient is untreated, however, the signs subsequently become more and more numerous, and eventually psychopathology is diagnosed.

Specific causes of pseudoneurotic schizophrenia are almost impossible to identify. However, risk factors are known, including:

  • Heredity.
  • Genetic mutations.
  • Neurotransmitter dysfunction.
  • Psychomotor disorders.
  • Uncomfortable social conditions.
  • Psychological trauma.

The development of the disorder usually occurs at a young age. As a rule, it is detected in adolescent boys. However, the risk of becoming ill persists into adulthood, and in both men and women.

Differences From Neurosis

The symptoms of neurotic schizophrenia are similar to those of neurosis. The following criteria allow us to differentiate the diagnosis:

  • Neurosis occurs after a strong psycho-emotional shock or as a result of prolonged stress. Schizophrenia can develop without obvious causes.
  • Neurotic people are aware of the illness; they understand that they need to seek help. Schizophrenics don’t see anything strange in their behavior. As a rule, they are brought to the appointment by their relatives.
  • Neurosis causes great discomfort in one’s personal life and work, but it doesn’t affect one’s sense of identity. Schizophrenia, even if it’s sluggish, leaves an imprint on personality traits, often leading to their complete disintegration.
  • The neurosis is successfully treated, and completely. Pseudoneurotic schizophrenia is well treated, but the diagnosis remains forever. The person will have to take medication and preventive care for the rest of their life.

Now let’s move on to the specific symptoms of neurotic-like schizophrenia. Some of these are part of the symptomatology of OCD.


Symptoms of the disease appear suddenly. And there can be a lot of them, depending on each individual case. They are divided into several groups: behavioral, psycho emotional, sensorimotor and cognitive. Let us list the most common ones.

Behavioral manifestations:

  • High-intensity obsessions. The person performs rituals for long periods of time without paying attention to comments from outside. Some patients wash their hands 3 to 5 times just before leaving the house, others count to a certain number before opening the door, etc.
  • Alienation. The patient withdraws from society, and communicates less with people, including loved ones. This is more out of necessity than out of the patient’s desire.
  • Changes in speech patterns. Strange abstract phrases appear in the person’s vocabulary, understandable only to him.
  • An atypical style of clothing. Often it is simply unkempt, but it can also be pretentious or overly garish.
  • Decrease in the range of interests. Even things that once interested the person very much are now indifferent to him/her.
  • Withdrawal from food. Sometimes it reaches the point of anorexia. At the same time, the motives for losing weight are not clear, as they are not connected to slenderness and beauty.
  • Suicide attempts. These occur in extreme cases, when the person cannot cope with his or her emotions and anxiety.

Psycho-emotional manifestations:

  • Mood swings for no reason.
  • Constant anxiety.
  • Several different emotions in one situation.
  • Anhedonia (inability to take pleasure).
  • Strange phobias (fear of the letter “K”, color, sound, etc.).
  • Hypochondria.
  • Suicidal moods.

Sensorimotor manifestations:

  • Depersonalization – sense of loss of self, loss of identity.
  • Dysmorphomania – a belief in the presence of defects or imperfections in one’s appearance, in one’s own ugliness.

All of this leads to the fact that the patient stops communicating with people. He begins to wear clothes that cover most of the body, and can even sign up for plastic surgery. Many patients are prone to anorexia and bulimia.

Cognitive manifestations:

  • Poor concentration.
  • A fine line between the real and the imaginary.
  • Impaired logical thinking.
  • Decreased 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 warrant seeking help from doctors.


OCD differs from schizophrenia in many ways. A doctor would never confuse the two disorders. Obsessions and compulsions are common. However, with neurosis, the person tries to overcome them or at least hide them. A schizophrenic does not do this, because he thinks he is doing well.

Neurotics retain their common sense. They are aware of their actions, even if they are done automatically, i.e. in the form of compulsions. At the same time, they understand that this condition is not normal. Moreover, they try to behave correctly. Only in severe cases the control completely disappears.

Schizophrenics, on the other hand, have split mental functions. They are not critical of their condition. They can behave defiantly or strangely, but they don’t realize that they cause shock to those around them. In other words, people with this form of schizophrenia perceive themselves as healthy.

Hallucinations in neurosis also occur, but they are short-lived and appear mostly before going to sleep, when the brain is tired, and after waking up, when brain activity is not as active as it is during the day. The OCD patient understands that the cause of the hallucinations is his illness.

In schizophrenia, voices and visions are spontaneous and may be chronic. Delusions and hallucinations can transport a person’s consciousness to another reality.

The main difference between OCD and schizophrenia is that the former does not cause a personality disorder. A person can completely get rid of the disorder without a trace to his or her consciousness. Schizophrenia leaves a defect; it affects the person’s self. In severe cases there is a complete disintegration of the personality.

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