Background: The co-morbid occurrence of anxiety disorders and schizophrenia has recently begun to be investigated. Social anxiety may be especially important to diagnose and manage among patients with schizophrenia.
Aim: To investigate the prevalence and correlates of social phobia in patients with schizophrenia.
Method: Diagnosis of schizophrenia and schizoaffective disorders as well as co-morbid anxiety disorders was established according to DSM-IV and the Structured Clinical Interview for Diagnosis (SCID-P Hebrew version). Severity of psychotic symptoms and social anxiety symptoms was assessed with the Positive and Negative Symptom Scale (PANSS) and the Liebowitz Social Anxiety Scale (LSAS).
Results: The cohort studied included 117 patients with schizophrenia. Thirteen patients were diagnosed as suffering from co-morbid social phobia (11%). There was a tendency for patients with co-morbid social phobia to have higher severity PANSS total score. There was a significant correlation between the score of the LSAS `fear' and PANSS positive subscales. Avoidance scores were higher among patients with negative signs.
Conclusion: Co-morbidity of schizophrenia and social anxiety disorder is not rare among patients with schizophrenia. Treatment implications need be further investigated.
Braga, R.J., Mendlowicz, M.V., Marrocos, R.P. & Figueira, I.L. (2005) Anxiety disorders in outpatients with schizophrenia: prevalence and impact on the subjective quality of life . Journal of Psychiatric Research, 39, 409-414.
2.
Cassano, G.B., Pini, S., Saettoni, M., Rucci, P. & Dell'Osso, L. (1998) Occurrence and clinical correlates of psychiatric co-morbidity in patients with psychotic disorders. Journal of Clinical Psychiatry, 59, 60-68.
3.
Cosoff, S.J. & Hafner, R.J. (1998) The prevalence of co-morbid anxiety in schizophrenia, schizoaffective disorder and bipolar disorder. Australian and New Zealand Journal of Psychiatry, 32, 67-72.
4.
Davidson, M. & Weiser, M. (2000) Early diagnosis of schizophrenia - the first step towards secondary prevention. Acta Psychiatrica Scandinavica , 400 (Suppl), 7-10.
5.
Dickerson, F., Boronow, J.J., Ringel, N. & Parente, F. (1999) Social functioning and neurocognitive deficits in outpatients with schizophrenia: a two-year follow-up. Schizophrenia Research, 37, 13-20.
6.
Goldberg, J.O. & Schmidt, L.A. (2001) Shyness, sociability, and social dysfunction in schizophrenia. Schizophrenia Research, 48, 343-349.
7.
Kendler, K.S., Gallagher, T.J., Abelson, J.M. & Kessler, R.C. (1996) Lifetime prevalence, demographic risk factors, and diagnostic validity of non-affective psychosis as assessed in a US community sample. The National Comorbidity Survey. Archive of General Psychiatry, 53, 1022-1031.
8.
Kay, S.R., Fiszbein, A. & Opler, L.A. (1987) The Positive and Negative Syndrome Scale for schizophrenia . Schizophrenia Bulletin, 13, 261-276.
9.
Kingsep, P., Nathan, P. & Castle, D. (2003) Cognitive behavioral group treatment for social anxiety in schizophrenia. Schizophrenia Research, 63, 121-129.
10.
Lysaker, P.H. & Salyers, M.P. (2007) Anxiety symptoms in schizophrenia spectrum disorders: associations with social function, positive and negative symptoms, hope and trauma history. Acta Psychiatrica Scandinavica, 116(4), 290-298.
11.
Liebowitz, M.R. (1987) Social phobia. Modern Problems of Pharmacopsychiatry, 22, 141-173.
12.
Packer, S., Husted, J., Cohen, S. & Tomlinson, G. (1997) Psychopathology and quality of life in schizophrenia . Journal of Psychiatry and Neuroscience, 22, 231-234.
13.
Pallanti, S., Quercioli, L. & Hollander, E. (2004) Social anxiety in outpatients with schizophrenia: a relevant cause of disability. American Journal of Psychiatry , 161, 53-58.
14.
Penn, D.L., Hope, D.A., Spaulding, W. & Kucera, J. (1994) Social anxiety in schizophrenia. Schizophrenia Research, 11, 277-284.
15.
Pilkonis, P.A., Feldman, H., Himmelhoch, J. & Cornes, C. (1980) Social anxiety and psychiatric diagnosis. Journal of Nervous and Mental Disease, 168, 13-18.
16.
Rocha, F.L., Vorcaro, C.M., Uchoa, E. & Lima-Costa, M.F. (2005) Comparing the prevalence rates of social phobia in a community according to ICD-10 and DSM-III-R. Occurrence and clinical correlates of psychiatric co-morbidity in patients with psychotic disorders. Revista Brasileira Psiquiatria, 27, 222-224.
17.
Spitzer, R.L., Williams, J.B.W., Gibbon, M. & First, M.B. (1990) Structured Clinical Interview for DSM-III-R- Patient Version 1.0 (SCID-P). Washington, DC: American Psychiatric Press.
