Anxiety and Schizophrenia: The Interaction of Subtypes of Anxiety and Psychotic Symptoms

CNS Spectrums ◽  
2005 ◽  
Vol 10 (9) ◽  
pp. 721-731 ◽  
Author(s):  
Jonathan D. Huppert ◽  
Thomas E. Smith
Keyword(s):  
Social Anxiety ◽  
Anxiety Disorders ◽  
Negative Symptoms ◽  
Rating Scales ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Psychotic Symptoms ◽  
Formal Thought Disorder ◽  
Obsessive Compulsive ◽  
Comorbid Anxiety

AbstractObjectiveTo examine the interaction of specific anxiety subtypes and psychosis.IntroductionAccumulating 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.MethodsThirty-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.ResultsA 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.DiscussionThis 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 psychopathologiesConclusionAnxiety 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.

scholarly journals Cognitive Behavioural Therapy for Auditory Hallucinations: Effectiveness and Predictors of Outcome in a Specialist Clinic

2010 ◽  
Vol 39 (2) ◽  
pp. 129-138 ◽  
Author(s):  
Neil Thomas ◽  
Susan Rossell ◽  
John Farhall ◽  
Frances Shawyer ◽  
David Castle
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Negative Symptoms ◽  
Rating Scales ◽  
Behavioural Therapy ◽  
Auditory Hallucinations ◽  
Psychotic Symptoms ◽  
Predictors Of Outcome ◽  
Formal Thought Disorder ◽  
Behavioural Treatment ◽  
Cognitive Behavioural

Background: Cognitive behavioural therapy has been established as an effective treatment for residual psychotic symptoms but a substantial proportion of people do not benefit from this treatment. There has been little direct study of predictors of outcome, particularly in treatment targeting auditory hallucinations. Method: The Psychotic Symptom Rating Scales (PSYRATS) and Positive and Negative Syndrome Scale (PANSS) were administered pre- and post-therapy to 33 people with schizophrenia-related disorders receiving CBT for auditory hallucinations in a specialist clinic. Outcome was compared with pre-therapy measures of insight, beliefs about the origin of hallucinations, negative symptoms and cognitive disorganization. Results: There were significant improvements post-treatment on the PSYRATS and PANSS Positive and General Scales. Improvement on the PSYRATS was associated with lower levels of negative symptoms, but was unrelated to overall insight, delusional conviction regarding the origins of hallucinations, or levels of cognitive disorganization. Conclusions: Lack of insight and presence of formal thought disorder do not preclude effective cognitive-behavioural treatment of auditory hallucinations. There is a need to further understand why negative symptoms may present a barrier to therapy.

scholarly journals Evaluation of the Clinical Global Impression Scale among individuals with social anxiety disorder

2003 ◽  
Vol 33 (4) ◽  
pp. 611-622 ◽  
Author(s):  
T. I. ZAIDER ◽  
R. G. HEIMBERG ◽  
D. M. FRESCO ◽  
F. R. SCHNEIER ◽  
M. R. LIEBOWITZ
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Anxiety Disorders ◽  
Social Anxiety Disorder ◽  
Clinical Global Impression ◽  
Severity Of Illness ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Clinical Global Impression Scale ◽  
Additional Variance

Background. The clinical Global Impression Scale (CGI) is commonly used as a primary outcome measure in studies evaluating the efficacy of treatments for anxiety disorders. The current study evaluated the psychometric properties and predictors of clinicians' ratings on an adapted version of the CGI among individuals with social anxiety disorders.Method. An independent assessor administered the CGI Severity of Illness and Improvement ratings to 123 patients at baseline and the subset of treated patients again mid- and post-treatment.Results. Improvement ratings were strongly related to both concurrent Severity of Illness and changes in Severity of Illness ratings from baseline. Additionally, both CGI ratings were positively correlated with both self-report and clinician-administered measures of social anxiety, depression, impairment and quality of life. Measures of social anxiety symptoms accounted for a large portion of the variance in Severity of Illness ratings, with significant additional variance accounted for by measures of impairment and depression. Changes in social anxiety symptoms from baseline accounted for significant variance in Improvement ratings, but no significant additional variance was accounted for by changes in impairment and depressive symptoms.Conclusions. Our findings support the utility of the CGI as an index of global severity and symptom-specific improvement among individuals with social anxiety disorder.

scholarly journals Anxiety Symptoms and Disorders in College Students With ADHD

2017 ◽  
Vol 24 (12) ◽  
pp. 1764-1774 ◽  
Author(s):  
Sarah R. O’Rourke ◽  
Allison C. Bray ◽  
Arthur D. Anastopoulos
Keyword(s):  
College Students ◽  
Anxiety Disorders ◽  
Self Efficacy ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Lifetime History ◽  
Students With Adhd ◽  
Maladaptive Beliefs

Objective: This study examined anxiety symptoms and disorders in college students with ADHD. Method: Forty-six college students with ADHD and a matched group of students without ADHD participated. Participants completed self-report measures of anxiety symptoms and associated features, including worry, maladaptive beliefs about worry, panic symptoms, social anxiety, obsessive-compulsive symptoms, and self-efficacy. Participants also completed a diagnostic interview to assess lifetime and current anxiety disorders. Results: Participants with ADHD endorsed more maladaptive beliefs about worry, more obsessive-compulsive symptoms, and poorer self-efficacy compared with comparison participants. There were no group differences in rates of current anxiety disorders. Participants with ADHD were over 2 times more likely than comparison participants to endorse this lifetime history. Conclusion: College students with ADHD are more likely to have a lifetime history of an anxiety disorder and are at greater risk for some anxiety symptoms and associated features.

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

CNS Spectrums ◽  
2007 ◽  
Vol 12 (12) ◽  
pp. 913-919 ◽  
Author(s):  
Antonio Ciapparelli ◽  
Rosemma Paggini ◽  
Donatella Marazziti ◽  
Claudia Carmassi ◽  
Maria Bianchi ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Rating Scale ◽  
Severity Of Illness ◽  
Psychotic Symptoms ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Comorbid Anxiety ◽  
Axis I

ABSTRACTIntroductionComorbid anxiety disorders are frequently encountered in psychoses and mainly assessed during the hospitalization.MethodsComorbidity 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.ResultsOne 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.ConclusionAnxiety 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.

scholarly journals Social anxiety in a multiple sclerosis clinic population

2009 ◽  
Vol 15 (3) ◽  
pp. 393-398 ◽  
Author(s):  
K Poder ◽  
K Ghatavi ◽  
JD Fisk ◽  
TL Campbell ◽  
S Kisely ◽  
...  
Keyword(s):  
Social Anxiety ◽  
Depression Scale ◽  
Research Unit ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Neurological Disability ◽  
General Anxiety ◽  
Neurologic Disability

Background Little is known about social anxiety in MS. Objective We estimated the prevalence of social anxiety symptoms and their association with demographic and clinical features in a clinic-attending sample of patients with MS. Methods Patients attending the Dalhousie MS Research Unit for regularly scheduled visits completed the Social Phobia Inventory (SPIN), the Hospital Anxiety and Depression Scale (HADS), and the Health Utilities Index (HUI). Neurological disability was determined by ratings on the Expanded Disability Status Scale (EDSS). Results A total of 251 patients completed self-report scales of anxiety and depression symptoms. In all, 245 (98%) provided sufficient data for analysis. In all, 30.6% ( n = 75) had clinically significant social anxiety symptoms as defined by a SPIN threshold score of 19. Half of those with social anxiety had general anxiety (HADSA ≥ 11) and a quarter had depression (HADSD ≥ 11). Severity of social anxiety symptoms was associated with reduced health-related quality of life and not related to neurological disability. Conclusions Social anxiety symptoms are common in persons with MS, contribute to overall morbidity, but are unrelated to the overall severity of neurologic disability. Greater awareness and routine systematic inquiry of social anxiety symptoms is an important component of comprehensive care for persons with MS.

Symptoms of Psychoses

1995 ◽  
Vol 166 (2) ◽  
pp. 236-240 ◽  
Author(s):  
Toshinori Kitamura ◽  
Yuji Okazaki ◽  
Akira Fujinawa ◽  
Masahiro Yoshino ◽  
Yomishi Kasahara
Keyword(s):  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Current Knowledge ◽  
Psychiatric Patients ◽  
Psychotic Symptoms ◽  
Formal Thought Disorder ◽  
Affective Symptoms ◽  
Five Factors ◽  
Thought Disorders ◽  
Positive And Negative Symptoms

BackgroundThe literature on the statistical analysis of symptoms of psychoses was limited to positive and negative symptoms in schizophrenia. The present study explored the relationship between positive and negative symptoms as well as affective symptoms in a wider category of psychotic disorders.MethodThe symptoms of 584 psychiatric patients, consecutively admitted to any of the 95 mental hospitals in Japan, were studied. They manifested at least one of the following: (a) delusions, (b) hallucinations, (c) formal thought disorder, (d) catatonic symptoms, or (e) negative (defect) symptoms.ResultsFactor analysis yielded five factors interpretable as (a) manic symptoms, (b) depressive symptoms, (c) negative (defect) symptoms and formal thought disorders, (d) positive (psychotic) symptoms, and (e) catatonic symptoms.ConclusionThese results suggest that although major symptoms seen among psychotic patients can be categorised into positive, negative, manic, and depressive groups, corresponding to current knowledge of phenomenology, catatonic symptoms constitute a discrete syndrome, while formal thought disorders merge into the negative syndrome.

Measuring social anxiety and obsessive-compulsive spectra: Comparison of interviews and self-report instruments

2002 ◽  
Vol 43 (2) ◽  
pp. 81-87 ◽  
Author(s):  
Liliana Dell'Osso ◽  
Paola Rucci ◽  
Giovanni B. Cassano ◽  
Jack D. Maser ◽  
Jean Endicott ◽  
...  
Keyword(s):  
Social Anxiety ◽  
Self Report ◽  
Obsessive Compulsive

An Approach to Comorbidity Between Obsessive-Compulsive Disorder and Schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. S495-S495
Author(s):  
A. Gomez Peinado ◽  
S. Cañas Fraile ◽  
P. Cano Ruiz
Keyword(s):  
Mental Health ◽  
Obsessive Compulsive Disorder ◽  
Negative Symptoms ◽  
Behavioral Therapy ◽  
Psychotic Symptoms ◽  
Simultaneous Presence ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Salud Mental ◽  
Competing Interest

IntroductionAn association has been observed between obsessive symptoms in Obsessive Compulsive Disorder (OCD) and psychotic symptoms in schizophrenia, being sometimes difficult to establish a clear limit between them. The term “schizo-obsessive disorder” was proposed to describe the resulting disorder of comorbidity of OCD and schizophrenia, although it has not been definitely settled.ObjectiveTo analyze the incidence of coexistence of OCD and schizophrenia symptoms and the way it modifies the treatment and prognosis of the illness.MethodReview of some articles published in Mental Health journals such as “Salud Mental” and “Actas Españolas de Psiquiatría”.ResultsSome studies about psychotic patients have determined 15% as the average of comorbidity of OCD and schizophrenia. The probability of having OCD is six times bigger if there is psychotic pathology associated.The fact that obsessive and psychotic symptoms get together in some patients shades the prognosis bringing more negative symptoms, more depressive humor, a larger cognitive impairment, more resistance to treatment and more relapses than we can observe in OCD and schizophrenia isolated.The pharmacological treatment usually consists in neuroleptic plus anti-obsessive drugs, together with cognitive-behavioral therapy. Sometimes, when there is a very bad evolution, it is required to consider psychosurgery as one necessary option, even though its use in this context is not much widespread.ConclusionsThe simultaneous presence of OCD and schizophrenia is more common than we could expect only by chance and makes the prognosis worse, being difficult to find a truly effective treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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