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

Abstract

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.

The Prevalence and Correlates of Social Anxiety Symptoms among People with Schizophrenia in Ethiopia: An Institution-Based Cross-Sectional Study

“…On the other hand, our finding is higher than those of studies done in Nigeria 17% [21], Israel 11% [11], Turkey 4.76% [15], Britain 25% [14], Brazil 17% [25], and Canada 14.9% [38]. The variations in the above rates might be due to differences in the types of study designs, sample sizes, the uses of various scales and ratings for assessing the level of social anxiety symptoms, methodologies, and sociocultural contrasts between Ethiopia and other countries.…”

“…The severity of psychotic episode in acute phase of schizophrenia predicted the severity of concurrent depression/anxiety symptoms [46]. The severity of schizophrenia symptoms increased the symptoms of social phobia symptoms [22], and patients diagnosed with comorbid schizophrenia and social anxiety symptoms had significantly higher scores on the mean PANSS [21]. Poor social support was five times a greater risk for social anxiety symptoms than good social support.…”

“…Several factors appear to influence the risk of social anxiety among individuals with schizophrenia. These include duration of illness, multiple episodes, low quality of life, impaired function, relapse, suicide attempts, number of hospitalizations, severity of the symptoms, and disability [20][21][22][23][24]. Evidence suggests that social anxiety contributes to a serious decrease in treatment outcomes and functional impairments [11,25].…”