Obsessionality and schizophrenia.

While there is much reference to the relationship between obsessive-compulsive phenomena and the affective disorders (11,15,19,22) less emphasis is given to the co-existence of obsessive-compulsive phenomena and schizophrenia. However, Sullivan (23) has commented extensively on the relationship between obsessional states and schizophrenia, and described that the one condition may shift to the other and back again. Rosen (18) describes the occurrence of obsessive-compulsive symptoms in the prodromal phase or during the course of schizophrenia, and schizophrenic symptoms which supervene in a long-standing obsessional neurosis. Obsessions, as defined by Kolb (11) are ideas, emotions, or impulses that repeatedly and persistently intrude themselves into consciousness even though they are unwanted, and are so tenacious that they cannot be dispelled by conscious effort or influenced by logic or reason. Schneider (21) emphasizes that the person realizes that the instrusive thinking is senseless and illogical and Lewis (13) remarks that the essential element is the subject's wish to resist the impulse, and that the thinking is recognized by the subject as foreign and alien to him and that he has insight into this. Obsessional thinking is the hallmark of obsessional neurosis, which may be accompanied by compulsive behaviour. The anal character type as described by Freud (4),