Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-19T04:48:45.779Z Has data issue: false hasContentIssue false
  • English
  • Français

Comorbidity with Axis I Anxiety Disorders in Remitted Psychotic Patients 1 Year After Hospitalization

Published online by Cambridge University Press:  07 November 2014

Antonio Ciapparelli ,
Rosemma Paggini ,
Donatella Marazziti ,
Claudia Carmassi ,
Maria Bianchi ,
Claudia Taponecco ,
Giorgio Consoli ,
Valentina Lombardi ,
Gabriele Massimetti  and
Liliana Dell'Osso
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

Comorbid anxiety disorders are frequently encountered in psychoses and mainly assessed during the hospitalization.

Methods

Comorbidity was investigated in 98 patients with schizophrenia, schizoaffective, or bipolar disorder, previously hospitalized for psychotic symptoms. Assessments, including Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Brief Psychiatric Rating Scale, and Clinical Global Impressions Scale, were performed during hospitalization (t0) and subsequently in a phase of remission (t1). Comorbidity was assessed at t1 only.

Results

One or more comorbid anxiety diagnoses were made in 46 (46.9%) patients. Of these, 15 (32.6%) received multiple anxiety diagnoses, while 31 (67.4%) single anxiety diagnoses. Schizophrenic patients had a rate of social anxiety disorder (SAD) higher (P<.05) than the others. Patients assessed with panic disorder or with obsessive-compulsive disorder at t1 showed significantly greater severity of illness at t0; patients with SAD demonstrated greater severity at t1. No significant differences in the rates of individual anxiety disorders were found in patients treated with typical or atypical antipsychotics or with both.

Conclusion

Anxiety disorders, particularly obsessive-compulsive disorder, panic disorder and SAD, seem to be frequently comorbid in remitted psychotic patients; SAD would be more prevalent in schizophrenia and might negatively impact the course of the illness.

Type
Original Research
Information
CNS Spectrums , Volume 12 , Issue 12 , December 2007 , pp. 913 - 919
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Muller, JE, Koen, L, Soraya, S, Emsley, RA, Stein, DJ. Anxiety disorders and schizophrenia. Curr Psychiatry Rep. 2004;6:255–261.CrossRefGoogle ScholarPubMed
2.Blanchard, JJ, Mueser, KT, Bellack, AS. Anhedonia, positive and negative affect, and social functioning in schizophrenia. Schizophr Bull. 1998;24:413–424.CrossRefGoogle ScholarPubMed
3.Cassano, GB, Pini, S, Saettani, M, Dell'Osso, L. Multiple anxiety disorder comorbidity in patients with mood spectrum disorders with psychotic features. Am J Psychiatry. 1999;156:474–476.CrossRefGoogle ScholarPubMed
4.Huppert, JD, Weiss, KA, Lim, R, Pratt, S, Smith, TE. Quality of life in schizophrenia: contributions of anxiety and depression. Schizophr Res. 2001;51:171–180.CrossRefGoogle ScholarPubMed
5.Wetherell, JL, Palmer, BW, Thorp, SR, Patterson, TL, Golshan, S, Jeste, DV. Anxiety symptoms and quality of life in middle-aged and older outpatients with schizophrenia and schizoaffective disorder. J Clin Psychiatry. 2003;64:1476–1482.CrossRefGoogle ScholarPubMed
6.Braga, RJ, Mendlowicz, MV, Marrocos, RP, Figueira, IL. Anxiety disorder in outpatients with schizophrenia: prevalence and impact on the subjective quality of life. J Psychiatr Res. 2005;39:409–414.CrossRefGoogle ScholarPubMed
7.Taiminen, T, Huttunen, J, Heila, H, et al.The Schizophrenia Suicide Risk Scale (SSRS): development and Initial validation. Schizophr Res. 2001;47:199–213.CrossRefGoogle ScholarPubMed
8.Craig, T, Hwang, MY, Bromet, EJ. Obsessive-compulsive and panic symptoms in patients with first-admission psychosis. Am J Psychiatry. 2002;159:592–598.CrossRefGoogle ScholarPubMed
9.Braga, RJ, Petrides, G, Figueira, I. Anxiety disorders in schizophrenia. Compr Psychiatry. 2004;45:460–468.CrossRefGoogle ScholarPubMed
10.Byerly, M, Goodman, W, Acholonu, W, Bugno, R, Rush, AJ. Obsessive compulsive symptoms in schizophrenia: frequency and clinical features. Schizophr Res. 2005;76:309–316.CrossRefGoogle ScholarPubMed
11.Labbate, LA, Young, PC, Arana, GW. Panic disorder in schizophrenia. Can J Psychiatry. 1999;44:488–490.CrossRefGoogle ScholarPubMed
12.Tibbo, P, Swainson, J, Chue, RLeMelledo, JM. Prevalence and relationship to delusions and hallucinations of anxiety disorders in schizophrenia. Depress Anxiety. 2003;17:65–72.CrossRefGoogle ScholarPubMed
13.Kendler, KS, Gallagher, TJ, Abelson, JM, Kessler, RC. Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample. The National Comorbidity Survey. Arch Gen Psychiatry. 1996;53:1022–1031.CrossRefGoogle Scholar
14.Goodwin, R, Amador, XF, Malaspina, D, Yale, SA, Goetz, RR, Gorman, JM. Anxiety and substance use comorbidity among inpatients with schizophrenia. Schizophr Res. 2003;61:89–95.CrossRefGoogle ScholarPubMed
15.Pallanti, S, Quercioli, L, Hollander, E. Social anxiety in outpatients with schizophrenia: a relevant cause of disability. Am J Psychiatry. 2004;161:53–58.CrossRefGoogle ScholarPubMed
16.Resnick, SG, Bond, GR, Mueser, KT. Trauma and post-traumatic stress disorder in people with schizophrenia. J Abnorm Psychol. 2003;112:415–423.CrossRefGoogle ScholarPubMed
17.Cutler, JL, Siris, SG. “Panic-like” symptomatology in schizophrenic and schizoaffective patients with postpsychotic depression: observations and implications. Compr Psychiatry. 1991;32:465–473.CrossRefGoogle ScholarPubMed
18.First, MB, Spitzer, RL, Gibbon, M, Williams, JB. Structured Clinical Interview for DSM-IV Axis I Disorders, Patient Edition. SCID-I/P, Version 2.0. New York, NY: New York State Psychiatric Institute, Biometrics Research: 1994.Google Scholar
19.Overall, JE, Gorham, DR. The Brief Psychiatric Rating Scale. Psychol Rep. 1962;10:799–812.CrossRefGoogle Scholar
20.Guy, W. Clinical Global Impressions (CGI). ECDEU Assessment Manual for Psychopharmacology. revised (DHEW Publ No ADM 76-338). Rockville, Md: United States Department of Health Education and Welfare; 1976:218–222.Google Scholar
21.Conti, L. Repertorio delle scale di valutazione in psichiatria. Firenze, Italia: S.E.E. Società Editrice Europea di Nicodemo Maggiulli & C; 1999.Google Scholar
22.Sassaroli, S, Ruggiero, MG. La psicopatologia cognitiva del rimuginio. It J Behav Cogn Psychother. 2003;9:1.Google Scholar
23.Cassano, GB, Pini, S, Saettani, M, Rucci, P, Dell'Osso, L. Occurrence and clinical correlates of psychiatric comorbidity in patients with psychotic disorders. J Clin Psychiatry. 1998;59:60–68.CrossRefGoogle ScholarPubMed
24.Cosoff, SJ, Hafner, RJ. The prevalence of comorbid anxiety in schizophrenia, schizoaffective disorder, and bipolar disorder. Aust N Z J Psychiatry. 1998;32:67–72.CrossRefGoogle ScholarPubMed
25.Pilkonis, PA, Feldman, H, Himmelhoch, J, Cornes, C. Social anxiety and psychiatric diagnosis. J Nerv Ment Dis. 1980;168:13–18.CrossRefGoogle ScholarPubMed
26.Addington, J, Addington, D. Premorbid functioning, cognitive functioning, symptoms and outcome in schizophrenia. J Psychiatry Neurosci. 1993;18:18–23.Google ScholarPubMed
27.Penn, DL, Hope, DA, Spaulbing, W, Kucera, J. Social anxiety in schizophrenia. Schizophr Res. 1994;11:277–284.CrossRefGoogle ScholarPubMed
28.Malmberg, A, Lewis, G, David, A, Allebeck, P. Premorbid adjustment and personality in people with schizophrenia. Br J Psychiatry. 1998;172:308–313.CrossRefGoogle ScholarPubMed
29.Krabbendaum, L, Janssen, I, Bijl, RV, Volleberg, WAM, Van Os, J. Neuroticism and low self esteem as risk factors for psychosis. Soc Psychiatry Psychiatr Epidemiol. 2002;37:1–6.CrossRefGoogle Scholar
30.Gumley, A, O'Grady, M, Power, K, Schwannauer, M. Negative beliefs about self and illness: a comparison of individuals with psychosis with or without comorbid social anxiety disorder. Aust N Z J Psychiatry. 2004;38:960–964.CrossRefGoogle ScholarPubMed
31.Cannon, M, Walsh, E, Hollis, C, et al.Predictors of later schizophrenia and affectives psychosis among attendees at a child psychiatry department. Br J Psychiatry. 2001;178:420–426.CrossRefGoogle Scholar
32.Wittchen, HU, Fuetsch, M, Sonntag, H, Muller, N, Liebowitz, M. Disability and quality of life in pure and comorbid social phobia-findings from a controlled study. Eur Psychiatry. 1999;14:118–131.CrossRefGoogle ScholarPubMed
33.Katzelnick, DJ, Kobak, KA, DeLeire, T, et al.Impact of generalized social anxiety disorder in managed care. Am J Psychiatry. 2001;158:1999–2007.CrossRefGoogle ScholarPubMed
34.Boylan, KR, Bieling, PJ, Marriott, M, Begin, H, Young, LT, MacQueen, GM. Impact of comorbid anxiety disorders on outcome in a cohort of patients with bipolar disorder. J Clin Psychiatry. 2004;65:1106–1113.CrossRefGoogle Scholar
35.Valenca, AM, Nardi, AE, Nascimento, I, et al.Do social anxiety disorder patients belong to a bipolar spectrum subgroup? J Affect Disord. 2005;86:11–18.CrossRefGoogle ScholarPubMed
36.Baker, RW, Chengappa, KN, Baird, JW, Steingard, S, Chirst, MA, Schooler, NR. Emergence of obsessive-compulsive symptoms during treatment with clozapine. J Clin Psychiatry. 1992;53:439–442.Google ScholarPubMed
37.Patel, B, Tandon, R. Development of obsessive-compulsive symptoms during clozapine treatment. Am J Psychiatry. 1993;150:836.Google ScholarPubMed
38.Eales, MJ, Layeni, O. Exacerbation of obsessive-compulsive symptoms associated with clozapine. Br J Psychiatry. 1994;164:687–688.CrossRefGoogle ScholarPubMed
39.Kopala, L, Honer, WG. Risperidone, serotoninergic mechanisms, and obsessive-compulsive symptoms in schizophrenia. Am J Psychiatry. 1994;151:1714–1715.Google Scholar
40.Remington, G, Adams, M. Risperidone and obsessive-compulsive symptoms. J Clin Psychopharmacol. 1994;14:358–359.CrossRefGoogle ScholarPubMed
41.Morrison, D, Clark, D, Goldfarb, E, McCoy, L. Worsening of obsessive-compulsive symptoms following treatment with olanzapine. Am J Psychiatry. 1998:155:855.Google ScholarPubMed
42.Rahman, MS, Grace, JJ, Pato, MT, Priest, B. Sertraline in the treatment of clozapine-induced obsessive-compulsive behavior. Am J Psychiatry. 1998;155:1629–1630.CrossRefGoogle ScholarPubMed
43.Mottard, JP, de la Sablonniere, JF. Olanzapine-induced obsessive-compulsive disorder. Am J Psychiatry. 1999:156:799–800.CrossRefGoogle ScholarPubMed
44.Biondi, M, Fedele, L, Arcangeli, T, Pancheri, P. Development of obsessive-compulsive symptoms during clozapine treatment in schizophrenia and its positive response to clomipramine. Psychother Psychosom. 1999:68:111–112.CrossRefGoogle ScholarPubMed
45.de Haan, L, Beuk, N, Hoogenboom, B, Dingemans, P, Linszen, D. Obsessive-compulsive symptoms during treatment with olanzapine and risperidone: a prospective study of 113 patients with recent-onset schizophrenia or related disorders. J Clin Psychiatry. 2002;63:104–107.CrossRefGoogle ScholarPubMed
46.Lykouras, L, Alevizos, B, Michalopoulou, P, Rabavilas, A. Obsessive-compulsive symptoms induced by atipical antipsychotics. A review of the reported cases. Prog Neuropsychopharmacol Biol Psychiatry. 2003;27:333–346.CrossRefGoogle Scholar