Schizophrenia dissection by five anxiety and depressive subtype comorbidities: Clinical implications and evolutionary perspective

Psychiatry Res. 2017 Nov:257:172-178. doi: 10.1016/j.psychres.2017.07.048. Epub 2017 Jul 26.

Abstract

Twenty patients with DSM5 schizophrenia were comprehensively and formally assessed by an experienced psychiatrist. All subjects were assessed for: positive and negative psychotic symptoms; social anxiety; panic anxiety; obsessive compulsive disorder, atypical depression; major depression; suicide risk; and global assessment of functioning. Different profiles of clinical presentation and symptom evolution emerged for patients with schizophrenia who had co-morbid depression (15%), OCD (15%), panic or limited symptom attacks (55%) and social anxiety (5%). At least eighty percent of the sample had one or more of these co-morbidities. Summing up, the data support our previous finding that panic is highly prevalent in Schizophrenia with Auditory Hallucinations (>73% here, versus 100% before), and panic was paroxysmally concurrent with voice onset. Moreover, characteristic clinical findings may help point clinicians to five specific co-morbidity psychosis subtypes. Moreover, co-morbidity dissection of psychotic diagnoses recalls and parallels the historical psychopharmacologic dissection of non-psychotic anxiety and depressive subtypes diagnoses. Larger studies should further test and explore these preliminary findings.

Keywords: Atypical Depression; Comorbidity; Evolution; Melancholia; OCD; Panic; Psychiatry; Schizophrenia; Social Anxiety.

MeSH terms

  • Adult
  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / psychology
  • Comorbidity
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / epidemiology*
  • Depressive Disorder, Major / psychology
  • Female
  • Hallucinations / diagnosis
  • Hallucinations / epidemiology
  • Hallucinations / psychology
  • Humans
  • Male
  • Middle Aged
  • Obsessive-Compulsive Disorder / diagnosis
  • Obsessive-Compulsive Disorder / epidemiology
  • Obsessive-Compulsive Disorder / psychology
  • Panic Disorder / diagnosis
  • Panic Disorder / epidemiology
  • Panic Disorder / psychology
  • Pilot Projects
  • Prevalence
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / psychology
  • Retrospective Studies
  • Schizophrenia / diagnosis*
  • Schizophrenia / epidemiology*
  • Schizophrenic Psychology