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Commentary
February 1999

The Natural History of Obsessive-compulsive Disorder

Arch Gen Psychiatry. 1999;56(2):131-132. doi:10.1001/archpsyc.56.2.131

IN 1982, Owens et al1 published an article in the ARCHIVES describing the prevalence of abnormal involuntary movements in 47 patients with chronic schizophrenia. The etiology and pathogenesis of tardive dyskinesia were matters of intense speculation then, and articles on this topic were not unusual. What was remarkable about this article were the patients: owing to the treatment policy of the hospital section in which they had been confined since the onset of their illness 10 to 56 years earlier, none had ever been exposed to neuroleptic drugs. Using rigorous assessment methods, this study confirmed the anecdotal observations of earlier investigators from the preneuroleptic era, who had noted that spontaneous dyskinesias were a frequent occurrence in schizophrenia. In so doing, Owens et al made a singular contribution to our understanding of schizophrenia and tardive dyskinesia that remains unique in the virtual impossibility of its ever being replicated.

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