Prevalence and clinicians’ awareness of psychiatric comorbidities among first–episode schizophrenia

Abstract

Background To explore the prevalence and clinicians’ awareness of psychiatric comorbidities, and to identify factors associated with current psychiatric comorbidities in first–episode schizophrenia (FES) patients. Method In this cross–sectional study, 128 patients with FES, who were in symptomatic remission, were consecutively recruited from a local early intervention clinic. All patients were interviewed using the Chinese bilingual version of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Axis I Disorders, Positive and Negative Syndrome Scales, Scale to Assess Unawareness of Mental Disorder, Social and Occupational Functioning Assessment Scale, Simpson–Angus Scale, Barnes Akathisia Rating Scale and Abnormal Involuntary Movement Scale. Bivariate and multivariate analyses were performed to investigate factors associated with psychiatric comorbidities in FES patients. Results The lifetime and point prevalence of psychiatric comorbidities among FES patients were 47.7% and 27.3%, respectively. Current psychiatric comorbidities were documented on the medical records of 39.3% of the patients. The FES patients with current psychiatric comorbidities had a lower level of functioning. Depression in FES was also associated with akathisia. Conclusion Psychiatric comorbidities are prevalent among community FES patients. In addition to achieving symptomatic remission in schizophrenia, both treating psychiatric comorbidities and minimizing the side–effects of treatment, particularly akathisia, are fundamental for supporting FES patients in their journey to recovery.

‘I do not know where it comes from, I am suspicious of some childhood trauma’ association of trauma with psychosis according to the experience of those affected

“…A recent systematic review obtained pooled median point and 12month prevalence values for psychotic disorders of 3.89 and 4.03 per 1000, respectively, with a median lifetime prevalence of 7.49 per 1000 (Moreno-Küstner, Martín, & Pastor, 2018). Furthermore, psychotic disorders are frequently associated with other psychopathological conditions, both during the first episode and throughout the course of the disorder (Buckley, Miller, Lehrer, & Castle, 2009;Hoertel et al, 2019;Singh, Beniwal, Bhatia, & Deshpande, 2019;Siu, Chong, & Lo, 2018;Tsai & Rosenheck, 2013). About 40% of patients with a first psychotic episode (FPE) have a current psychic comorbidity recorded in their medical history (Siu et al, 2018).…”

“…Furthermore, psychotic disorders are frequently associated with other psychopathological conditions, both during the first episode and throughout the course of the disorder (Buckley, Miller, Lehrer, & Castle, 2009;Hoertel et al, 2019;Singh, Beniwal, Bhatia, & Deshpande, 2019;Siu, Chong, & Lo, 2018;Tsai & Rosenheck, 2013). About 40% of patients with a first psychotic episode (FPE) have a current psychic comorbidity recorded in their medical history (Siu et al, 2018). Numerous studies have shown that, with respect to the general population, adults diagnosed with schizophrenia are more likely to suffer anxiety, depression, obsessive symptoms and substance use disorders (Buckley et al, 2009;Hoertel et al, 2019;Singh et al, 2019;Tsai & Rosenheck, 2013).…”

The relevance of transdiagnostic shared networks to the severity of symptoms and cognitive deficits in schizophrenia: a multimodal brain imaging fusion study

“…Evidence of such transdiagnostic overlap has also been reported in brain structural 5,6 and genetic [7][8][9] studies. Specifically, SZ diagnosis is frequently concurrent with substance use, such as smoking and drinking 10,11 , showing a prevalence of 50%, for example. Neuroimaging findings comparing substance use disorders and SZ show that they both involve reward network dysfunction related with impulsive control 10 .…”

The ‘revolving door’ of mental illness: A meta‐analysis and systematic review of current versus lifetime rates of psychological disorders

“…Two other studies used samples of patients with borderline personality disorder (McGirr et al., 2007; Tadic et al., 2009). One study each represented a sample of individuals diagnosed with the following disorders: OCD (Menzies et al., 2017), post‐traumatic stress disorder (PTSD; Gekker et al., 2018), binge eating disorder (Grilo et al., 2009), depression (Zimmerman et al., 2002), bipolar disorder (McElroy et al., 2001), schizophrenia (Siu et al., 2018), functional movement disorder (Epstein et al., 2016), ADHD (Edvinsson et al., 2013) and nicotine dependence (Piper et al., 2010).…”

“…For all included studies, the mean values and standard deviations for current and lifetime disorders were extracted, in addition to the number of participants. Of the 27 studies included in the meta‐analysis, the authors of 11 studies were contacted in order to obtain data that had not been reported (Arnberg et al., 2013; Brown et al., 2001; Chong et al., 2012; Grilo et al., 2009; Ormel et al., 2015; Piper et al., 2010; Shaffer et al., 2007; Siu et al., 2018; Subramaniam et al., 2019; Tabet et al., 2016; Thoma et al., 2021). The statistical analyses were conducted using Comprehensive Meta‐Analysis (CMA) Version 3.…”