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CNS Spectr. 2005 Sep;10(9):721-31.

Anxiety and schizophrenia: the interaction of subtypes of anxiety and psychotic symptoms.

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Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.



To examine the interaction of specific anxiety subtypes and psychosis.


Accumulating evidence suggests that anxiety and its disorders play a significant role in patients with schizophrenia, but few studies have examined multiple types of anxiety and how they interact with different symptoms of schizophrenia.


Thirty-two patients diagnosed with schizophrenia or schizoaffective disorder were assessed through self-report measures and interviewer rating scales to examine symptoms of psychosis and anxiety.


A majority of patients (62%) were diagnosed with at least one comorbid anxiety disorder. Obsessive-compulsive symptoms and social anxiety symptoms were related to positive symptoms, bizarre behavior, and quality of life (QOL). Furthermore, panic and social anxiety were related to suspiciousness/paranoia. No consistent relationship was found with negative symptoms. Finally, severity of anxiety disorders was negatively correlated with the severity of formal thought disorder.


This is one of the first studies to simultaneously examine the interrelationships of different types of anxiety symptoms and psychotic symptoms. The present findings are consistent with the studies that have suggested relationships between panic and paranoia and comorbid anxiety disorders and impaired QOL. These data suggest that further research into anxiety in schizophrenia, including the cognitive and neurobiological correlates, may help elucidate the mechanisms involved in the manifestation of these psychopathologies.


Anxiety disorders are common in patients with schizophrenia. The presence of such symptoms may influence the presence of core psychotic symptoms and QOL. More information is needed in terms of the relationship between treatment of these symptoms and changes in psychotic symptoms and/or relapse prevention.

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