Xu Ping, Wu Shanshan, Zhao Jie, Liu Junjun, Zhang Xiangyang
Department of Psychiatry, Nanjing Lishui District Psychiatric Hospital, Lishui, 211200, People's Republic of China.
Nanjing Department of Psychiatry, The Third People's Hospital of Lishui District, Lishui, 211200, People's Republic of China.
BMC Psychiatry. 2025 Jul 30;25(1):743. doi: 10.1186/s12888-025-07197-1.
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.
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.
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.
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.
尽管焦虑症状常与精神分裂症同时出现，并可能对疾病进展和治疗结果产生重大影响，但对这种共病的系统研究仍然有限。本研究旨在调查中国首发未用药精神分裂症（FEDN）患者中严重焦虑症状的患病率及其临床相关性。
这项横断面研究纳入了255例FEDN精神分裂症患者。收集了所有参与者的综合临床和人口统计学数据。使用阳性和阴性症状量表（PANSS）评估精神症状，同时分别使用14项汉密尔顿焦虑量表（HAMA-14）和24项汉密尔顿抑郁量表（HAMD-24）评估焦虑和抑郁症状。根据HAMA评分≥29定义的严重焦虑症状的有无，将参与者分为两组。采用多因素logistic回归分析确定FEDN精神分裂症患者中与严重焦虑症状相关的潜在因素。
FEDN精神分裂症患者中严重焦虑症状的患病率为51.8%（132/255）。多因素logistic回归分析显示，HAMD-24评分升高（OR = 1.17，95%CI：1.11 - 1.22，p < 0.001）和高密度脂蛋白胆固醇（HDL-c）水平升高（OR = 4.70，95%CI：1.53 - 14.4，p = 0.007）均与严重焦虑症状风险增加独立相关。曲线下面积（AUC）分析显示出不同的预测能力：HAMD-24具有较强的独立预测能力（AUC = 0.868），而HDL-c尽管在多变量回归中有统计学意义，但判别能力有限（AUC = 0.592）。
本研究强调了FEDN精神分裂症患者中严重焦虑症状的高患病率。我们的多变量分析确定HAMD-24评分和HDL-c水平是该人群中与严重焦虑症状相关的重要因素。这些发现加深了我们对FEDN精神分裂症焦虑机制的理解，可能为未来的治疗策略提供参考。
