Ciapparelli Antonio, Paggini Rosemma, Marazziti Donatella, Carmassi Claudia, Bianchi Maria, Taponecco Claudia, Consoli Giorgio, Lombardi Valentina, Massimetti Gabriele, Dell'osso Liliana
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Pisa, Italy.
CNS Spectr. 2007 Dec;12(12):913-9. doi: 10.1017/s1092852900015704.
Comorbid anxiety disorders are frequently encountered in psychoses and mainly assessed during the hospitalization.
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.
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.
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.
共病焦虑症在精神病患者中很常见,主要在住院期间进行评估。
对98例曾因精神病性症状住院的精神分裂症、分裂情感性障碍或双相情感障碍患者的共病情况进行了调查。评估包括《精神障碍诊断与统计手册》第四版的结构化临床访谈、简明精神病评定量表和临床总体印象量表,在住院期间(t0)以及随后的缓解期(t1)进行。仅在t1评估共病情况。
46例(46.9%)患者被诊断出一种或多种共病焦虑症。其中,15例(32.6%)被诊断为多种焦虑症,31例(67.4%)为单一焦虑症。精神分裂症患者的社交焦虑障碍(SAD)发生率高于其他患者(P<0.05)。在t1时被诊断为惊恐障碍或强迫症的患者在t0时疾病严重程度明显更高;患有SAD的患者在t1时疾病严重程度更高。在使用典型或非典型抗精神病药物或两者兼用治疗的患者中,个体焦虑症的发生率没有显著差异。
焦虑症,尤其是强迫症、惊恐障碍和SAD,似乎在缓解期的精神病患者中经常共病;SAD在精神分裂症中可能更普遍,并且可能对疾病进程产生负面影响。