Book contents
- Management of Complex Treatment-Resistant Psychotic Disorders
- Management of Complex Treatment-Resistant Psychotic Disorders
- Copyright page
- Contents
- Contributors
- Acknowledgements
- Abbreviations
- List of Icons
- Introduction
- Part I Treatment Strategies
- 1.01 Approaches to Positive Psychotic Symptoms
- 1.02 Use of Plasma Levels in Antipsychotic and Mood Stabilizer Treatment
- 1.03 Advantages of Long-Acting Injectable Antipsychotics
- 1.04 Approach to Treatment-Resistant Schizophrenia Spectrum Patients
- 1.05 Approach to Depressed or Suicidal Schizophrenia Spectrum Patients
- 1.06 Approach to Persistent Aggression and Violence in Schizophrenia Spectrum Psychotic Disorders
- 1.07 Approach to Bipolar Diathesis in Schizophrenia Spectrum Patients
- 1.08 Approach to Anxiety in Schizophrenia Spectrum Patients
- 1.09 Approach to Insomnia and Sleep Disturbance in Schizophrenia Spectrum Disorders
- 1.10 Approach to Psychosis in Children and Adolescents
- 1.11 Electroconvulsive Therapy and Other Non-Pharmacological Treatments
- 1.12 Approach to Substance Use Disorders in Schizophrenia Spectrum Disorders
- 1.13 Approaches to Behavioral Disturbances in Dementia and Traumatic Brain Injury Patients
- Part II Medication Reference Tables
- Appendices
- Index
- References
1.08 - Approach to Anxiety in Schizophrenia Spectrum Patients
from Part I - Treatment Strategies
Published online by Cambridge University Press: 19 October 2021
Book contents
- Management of Complex Treatment-Resistant Psychotic Disorders
- Management of Complex Treatment-Resistant Psychotic Disorders
- Copyright page
- Contents
- Contributors
- Acknowledgements
- Abbreviations
- List of Icons
- Introduction
- Part I Treatment Strategies
- 1.01 Approaches to Positive Psychotic Symptoms
- 1.02 Use of Plasma Levels in Antipsychotic and Mood Stabilizer Treatment
- 1.03 Advantages of Long-Acting Injectable Antipsychotics
- 1.04 Approach to Treatment-Resistant Schizophrenia Spectrum Patients
- 1.05 Approach to Depressed or Suicidal Schizophrenia Spectrum Patients
- 1.06 Approach to Persistent Aggression and Violence in Schizophrenia Spectrum Psychotic Disorders
- 1.07 Approach to Bipolar Diathesis in Schizophrenia Spectrum Patients
- 1.08 Approach to Anxiety in Schizophrenia Spectrum Patients
- 1.09 Approach to Insomnia and Sleep Disturbance in Schizophrenia Spectrum Disorders
- 1.10 Approach to Psychosis in Children and Adolescents
- 1.11 Electroconvulsive Therapy and Other Non-Pharmacological Treatments
- 1.12 Approach to Substance Use Disorders in Schizophrenia Spectrum Disorders
- 1.13 Approaches to Behavioral Disturbances in Dementia and Traumatic Brain Injury Patients
- Part II Medication Reference Tables
- Appendices
- Index
- References
Summary
Large studies and meta-analyses have noted that anxiety symptoms can occur in up to 65% of patients with schizophrenia, and the prevalence of any anxiety disorder (at the syndromal level) is estimated to be up to 38% [1, 2]. Anxiety symptoms are thus commonly encountered when treating patients with chronic psychotic disorders; however, of equal importance is the conclusion that more than 40% of schizophrenia spectrum patients who report an anxiety symptom are suffering from a cause other than a primary anxiety disorder or depression with anxiety. The differential diagnosis of anxiety symptoms is quite broad among patients with chronic psychotic disorders, but the correct action depends greatly on the underlying etiology. Reflexive use of a benzodiazepine or a selective serotonin reuptake inhibitor (SSRI) to treat anxiety is not appropriate in many instances and can be associated with deleterious outcomes such as increased mortality (benzodiazepines), or antidepressant-induced destabilization of patients with a bipolar diathesis (i.e. patients with a diagnosis of schizoaffective disorder, bipolar type). The issues to consider in documenting a treatment rationale are outlined in Table 8.1. A thoughtful review of the anxiety symptom evolution in relationship to medication changes or other factors should enable the clinician to arrive at a testable hypothesis and plot a course of action.
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- Publisher: Cambridge University PressPrint publication year: 2021
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