How Prevalent Are Anxiety Disorders in Schizophrenia? A Meta-Analysis and Critical Review on a Significant Association

Abstract

Objective: The presence of anxiety disorders (AD) in schizophrenia (SZ) is attracting increasing interest. However, published studies have yielded very broad variations in prevalence rates across studies. The current meta-analysis sought to (1) investigate the prevalence of co-occurring AD in SZ by reporting pooled prevalence rates and (2) identify potential sources of variations in reported rates that could guide our efforts to identify and treat these co-occurring disorders in patients with SZ. Methods: We performed a systematic search of studies reporting prevalence of AD in SZ and related psychotic disorders. Mean prevalence rates and 95% confidence intervals (CIs) were first computed for each disorder. We then examined the impact of potential moderators related to patient sampling or to AD assessment methods on these rates. Results: Fiftytwo eligible studies were identified. Pooled prevalence rates and CIs were 12.1% (7.0%-17.1%) for obsessive-compulsive disorders, 14.9% (8.1%-21.8%) for social phobia, 10.9% (2.9%-18.8%) for generalized AD, 9.8% (4.3%-15.4%) for panic disorders, and 12.4% (4.0%-20.8%) for post-traumatic stress disorders. For all disorders, we found significant heterogeneity in rates across studies. This heterogeneity could at least partially be explained by the effect of moderator variables related to patient characteristics or assessment methods. Conclusions: AD are highly prevalent in SZ, but important variations in rates are observed between studies. This meta-analysis highlights several factors that affect risk for, or detection of AD in SZ, and could, thus, have an important impact on treatment and outcome of SZ patients.

Factor structure of the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) in a large sample of patients with schizophrenia or related disorders and comorbid obsessive–compulsive symptoms

“…Prevalence findings vary from 7.8% to as high as 55% (overview in Byerly et al, 2005;De Haan et al, 2002, 2004Achim et al, 2009). This wide range is primarily attributable to methodological differences, among others the instrument used to assess the severity of OCS.…”

Posttraumatic Stress Symptoms and Their Association With Smoking Outcome Expectancies Among Homeless Smokers in Boston

“…Since individuals with psychotic disorders may have distinct smoking outcome expectancy patterns 51 and may also have a high burden of trauma and PTSD, [52][53][54][55] we used past-30 day hallucinations from the ASI as a proxy for psychosis in the multivariable models. We explored whether gender modified the effect of PTSD on outcome expectancies by including an interaction term in the multivariable models; in all cases, this term was nonsignificant and therefore removed from the final models.…”

Beyond “Cold” Cognition: Exploring Cognitive Control of Emotion as a Risk Factor for Psychosis

“…Mood and anxiety symptoms are present in the majority of CHR [16,20] and PP individuals [36], as well as in individuals with a diagnosed psychotic disorder [37,38]. Moreover, comorbid mood and anxiety symptoms in high-risk populations relate to interpersonal sensitivity and paranoid ideation [39], delusions [40], negative symptoms [41], increased risk for transition to psychosis [35], and poorer psychosocial functioning overall [16].…”