The prevalence and clinical correlates of severe anxiety symptoms in first-episode drug-naïve schizophrenia: a Chinese population study.

OBJECTIVE

Although anxiety symptoms frequently co-occur with schizophrenia and may substantially influence disease progression and treatment outcomes, systematic investigations of this comorbidity remain limited. This study aimed to investigate the prevalence and clinical correlations of severe anxiety symptoms among Chinese patients with first-episode drug-naive (FEDN) schizophrenia.

METHODS

This cross-sectional study enrolled 255 FEDN schizophrenia patients. Comprehensive clinical and demographic data were collected from all participants. Psychiatric symptoms were assessed using PANSS, while anxiety and depression symptoms were evaluated using the 14-item Hamilton Anxiety Rating Scale (HAMA-14) and the 24-item Hamilton Depression Rating Scale (HAMD-24), respectively. Participants were stratified into two groups based on the presence or absence of severe anxiety symptoms, defined by a HAMA score ≥ 29. Multivariate logistic regression analysis was employed to identify potential correlates associated with severe anxiety symptoms in FEDN schizophrenia patients.

RESULTS

The prevalence of severe anxiety symptoms among patients with FEDN schizophrenia was 51.8% (132/255). Multivariable logistic regression analysis revealed that both elevated HAMD-24 scores (OR = 1.17, 95% CI: 1.11-1.22, p < 0.001) and higher high-density lipoprotein cholesterol (HDL-c) levels (OR = 4.70, 95% CI: 1.53-14.4, p = 0.007) were independently associated with increased risk of severe anxiety symptoms. The area under the curve (AUC) analysis revealed distinct predictive capabilities: HAMD-24 demonstrated strong standalone predictive ability (AUC = 0.868), while HDL-c showed limited discriminative capacity (AUC = 0.592) despite statistical significance in multivariable regression.

CONCLUSION

This study highlights the substantial prevalence of severe anxiety symptoms among patients with FEDN schizophrenia. Our multivariable analysis identified HAMD-24 scores and HDL-c levels as significant factors associated with severe anxiety symptoms in this population. These findings enhance our understanding of anxiety mechanisms in FEDN schizophrenia, potentially informing future treatment strategies.