The prevalence of comorbid anxiety in schizophrenia, schizoaffective disorder and bipolar disorder

Cosoff, Susan J.; Hafner, R. Julian

doi:10.1046/j.1440-1614.1998.00374.x

Cited by 89 publications

(119 citation statements)

References 18 publications

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“…Other studies of anxiety disorder in schizophrenia reported a higher anxiety rate of 43% 23 and 41.5% 22 . These higher rates may be explained by the use of in-patients who may report higher rates of anxiety than the out-patients 23 and the measurement of lifetime rates instead of current rate of anxiety disorder 11 .…”

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confidence: 79%

“…A study done in Australia on 100 consecutively admitted in-patients with schizophrenia found that anxiety disorders though common (45% in the patients studied), was unrecognized by clinicians in almost all of the patients 23 . Craig, Hwang and Bromet reported that only about 10 percent of patients with co-morbid obsessive compulsive symptoms were identified by the clinicians.…”

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confidence: 97%

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Co-morbid anxiety disorders in patients with schizophrenia in a tertiary institution in South East Nigeria: prevalence and correlates.

Aguocha

Uwakwe

et al. 2015

Afr H. Sci.

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Background: Anxiety disorders occur commonly in schizophrenia but are often overlooked by psychiatrists. Their presence may compound the challenges faced by these patients and may contribute to poor outcome. Objectives: The purpose of this study was to determine the prevalence of anxiety disorders among the participants with schizophrenia, and the association between this co-morbidity and disability. Method: A total of 367 participants were recruited from the out-patient department of Federal neuropsychiatric hospital Enugu, Nigeria. Socio-demographic questionnaire, schedules for clinical assessment in neuropsychiatry, positive and negative syndrome scale and the 12-item version of the World Health Organization disability assessment schedule were administered. Results: A total of 189 females (51.5%) and 178 (48.5%) males were studied. A lifetime prevalence of 12.3% was reported for anxiety disorder. Anxiety disorder was more likely in females (κ²=4.93, p<0.03). Specific prevalence for anxiety disorder in schizophrenia was generalized anxiety disorder 6.3%, obsessive compulsive disorder 3.3%, and phobic anxiety disorder 2.7%. Anxiety disorder was associated with increased disability (t=3.50, p<0.001) and psychopathology (t=3.40, p<0.001) among the participants studied. Phobias were associated with prescription of low doses of antipsychotics (κ²=4.08, p<0.04). There was a low rate of identification of anxiety disorder in routine clinical practice (k=0.08, p<0.001). Conclusion: Co-morbid anxiety disorders are common in schizophrenia and they are associated with increased disability and psychopathology. The results emphasize the need to screen for anxiety disorders in patients with schizophrenia.

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confidence: 79%

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confidence: 97%

Co-morbid anxiety disorders in patients with schizophrenia in a tertiary institution in South East Nigeria: prevalence and correlates.

Aguocha

Uwakwe

et al. 2015

Afr H. Sci.

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“…Three populationbased studies conducted in Italy and USA, reported lifetime prevalence rates of comorbid OCD in BD patients ranging between 11.1% and 21% (3,23,24). In hospital-based studies, the lifetime prevalence of comorbid OCD in BD patients ranged between 1.8% and 35.1% (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) depending on the features of the BD study population included (schizoaffective disorder, bipolar type). When restricting the analysis to studies with sample size greater than 250, the OCD-BD prevalence range was narrower (3-13.6%) (24,26,27,31,38,39), and the mean prevalence rate of BD-I comorbidity was 15%, while BD-II was 12.6% (24,38,39).…”

Section: Included Studiesmentioning

confidence: 99%

Diagnostic validity of comorbid bipolar disorder and obsessive–compulsive disorder: a systematic review

Amerio

Odone

Liapis

et al. 2014

Acta Psychiatr Scand

107

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Diagnostic validity of comorbid bipolar disorder and obsessive-compulsive disorder: a systematic review Amerio A, Odone A, Liapis CC, Ghaemi SN. Diagnostic validity of comorbid bipolar disorder and obsessive-compulsive disorder: a systematic review.Objective: At least 50% of bipolar disorder (BD) patients have an additional diagnosis, one of the most difficult to manage being obsessive-compulsive disorder (OCD). Defining the nosology of BD-OCD comorbidity has important clinical implications, given that treatments for OCD can worsen BD outcomes. Method: A systematic review was conducted on: i) BD-OCD comorbidity lifetime prevalence and ii) on standard diagnostic validators: phenomenology, course of illness, heredity, biological markers, and treatment response. Relevant papers published through March 30th 2013 were identified searching the electronic databases MEDLINE, Embase, PsycINFO, and the Cochrane Library. Results: Sixty-four articles met inclusion criteria. Lifetime comorbidity prevalence was 11-21% in BD patients and 6-10% in OCD patients. Compared to non-comorbid subjects, BD-OCD has a more episodic course of OC symptoms (up to 75% vs. 3%), typically with worsening during depression (78%) and improvement during mania/hypomania (64%), as well as a higher total mean number of depressive episodes (8.9 AE 4.2 vs. 4.1 AE 2.7) and perhaps more antidepressant-induced mania/hypomania (39% vs. 9%). Conclusion: In this first systematic review of BD-OCD comorbidity, it appears that OC symptoms are usually secondary to BD, rather than representing a separate disease. • The evidence so far on BD-OCD nosology-mainly based on the course of illness-supports the view that the majority of cases of comorbid BD-OCD are in fact cases of BD. OC symptoms usually are secondary manifestations of depressive or manic mood episodes.• BD-OCD patients may respond for both groups of symptoms with adequate doses of mood stabilizers and atypical antipsychotics. Because of the risk of worsening BD via SRI-induced mania/hypomania, antidepressants should only be used in a minority of refractory OCD. Considerations• Course of illness is the only diagnostic validator that clearly supports the OCD-BD construct as a subtype of BD. Findings on the phenomenology, heredity, biological markers, and treatment were fragmented and heterogeneous and mainly suggested increased severity of illness or functioning without helping us to answer the nosological question.• The use of retrospective assessment scales with unclear sensitivity in discriminating true ego-dystonic obsessions from depressive ruminations may have biased results toward an overestimation of obsession's prevalence. In addition, small sample sizes, mainly from out-patients units, may have limited the generalizability of the results to a whole community.

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“…Social anxiety is among the most prevalent and debilitating affective disturbances manifest in people with psychosis with rates ranging between 8% to 36% (1,2,3,4,5,6,7,8). Social anxiety is usually accompanied by high levels of depression and exerts a significant impact on social disability (2,5,7,8,9).…”

Section: Introductionmentioning

confidence: 99%

Social anxiety in first-episode psychosis: The role of childhood trauma and adult attachment

Michail

Birchwood

2014

Journal of Affective Disorders

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Michail, Maria and Birchwood, Max (2014) Social anxiety in first-episode psychosis: the role of childhood trauma and adult attachment. Journal of Affective Disorders, 163 . pp. 102-109. ISSN 1573-2517 Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/35476/1/Accepted%20manuscript.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the Creative Commons Attribution Non-commercial No Derivatives licence and may be reused according to the conditions of the licence. For more details see: http://creativecommons.org/licenses/by-nc-nd/2.5/ A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Method: This is a cross-sectional study. A sample of individuals with social anxiety disorder (with or without psychosis) was compared with a sample with psychosis only and healthy controls on childhood trauma, dysfunctional parenting and adult attachment.Results: Childhood trauma and dysfunctional parenting (p<0.05) were significantly elevated in people with social anxiety (with or without psychosis) compared to those with psychosis only and healthy controls. There were no differences in childhood trauma and dysfunctional parenting between socially anxious people with and without psychosis. Higher levels of insecure adult attachment (x 2 1 =38.5, p<0.01) were reported in the social anxiety group (with or without psychosis) compared to the psychosis only and healthy controls. Childhood adversities were not associated with insecure adult attachment in people with social anxiety (with or without psychosis).Limitations: Due to the cross-sectional nature of the study we cannot infer causal relationships between early risk factors, including childhood trauma and dysfunctional parenting, and social anxiety. Also, the use of self-report measures of attachment could be subject to biases. Conclusion:Shared developmental risk factors are implicated in the emergence of affective disorders in psychosis and non-psychosis. Social anxiety in psychosis is associated with insecurity in adult attachments which does not arise a result of adverse developmental pathways. Understanding the bio-psycho-social risk factors for...

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The prevalence of comorbid anxiety in schizophrenia, schizoaffective disorder and bipolar disorder

Cited by 89 publications

References 18 publications

Co-morbid anxiety disorders in patients with schizophrenia in a tertiary institution in South East Nigeria: prevalence and correlates.

Co-morbid anxiety disorders in patients with schizophrenia in a tertiary institution in South East Nigeria: prevalence and correlates.

Diagnostic validity of comorbid bipolar disorder and obsessive–compulsive disorder: a systematic review

Social anxiety in first-episode psychosis: The role of childhood trauma and adult attachment

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