Anxiety disorders in schizophrenia - the importance of differentiation and targeted treatment a case report and literature review
DOI:
https://doi.org/10.12775/QS.2024.20.53369Keywords
schizophrenia, comorbid anxiety disorders, paranoid schizophrenia, cognitive-behavioral therapy, antipsychotic medicationAbstract
Schizophrenia is a chronic mental disorder characterized by severe cognitive and behavioral impairments. It often coexists with multiple and complex anxiety symptoms that exacerbate the clinical challenges associated with schizophrenia. This case report presents the history of a 32-year-old woman with a final diagnosis of both paranoid schizophrenia and mixed anxiety disorders. The patient presented with persistent auditory pseudohallucinations, severe anxiety together with occasional panic attacks, which were treated with a variety of antipsychotics. Treatment adjustments were necessitated by the emergence of side effects, including neutropenia, motor disturbances and the observation of major anxiety symptoms, including panic disorder. Ultimately, the successful use of quetiapine in monotherapy was achieved. This case study emphasizes the need for comprehensive treatment strategies to address the complex interplay of psychotic and anxiety symptoms. Increased clinical awareness and targeted treatment of comorbid anxiety can significantly improve the quality of life of patients with schizophrenia.
References
Achim, A. M., Maziade, M., Raymond, É., Olivier, D., Mérette, C., & Roy, M. A. (2011). How prevalent are anxiety disorders in schizophrenia? A meta-analysis and critical review on a significant association. Schizophrenia Bulletin, 37(4), 811-821.
https://doi.org/10.1093/schbul/sbp148
Braga, R. J., Reynolds, G. P., & Siris, S. G. (2013). Anxiety comorbidity in schizophrenia. Psychiatry Research, 210(1), 1-7.
https://doi.org/10.1016/j.psychres.2013.07.030
Buckley, P. F., Miller, B. J., Lehrer, D. S., & Castle, D. J. (2009). Psychiatric comorbidities and schizophrenia. Schizophrenia Bulletin, 35(2), 383-402.
https://doi.org/10.1093/schbul/sbn135
Grillo, L. (2018). A possible link between anxiety and schizophrenia and a possible role of anhedonia. Schizophrenia Research and Treatment, 2018, 1-8.
https://doi.org/10.1155/2018/5917475
Hofmann, S. G., & Smits, J. A. (2008). Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. Journal of Clinical Psychiatry, 69(4), 621-632.
https://doi.org/10.4088/jcp.v69n0415
Kesby, J. P., Eyles, D. W., McGrath, J. J., & Scott, J. G. (2018). Dopamine, psychosis and schizophrenia: The widening gap between basic and clinical neuroscience. Translational Psychiatry, 8(1), 30.
https://doi.org/10.1038/s41398-017-0071-9
Kiran, C., & Chaudhury, S. (2016). Prevalence of comorbid anxiety disorders in schizophrenia. Industrial Psychiatry Journal, 25(1), 35–40.
https://doi.org/10.4103/0972-6748.196045
Nierop, M., Viechtbauer, W., Gunther, N., van Zelst, C., de Graaf, R., ten Have, M., van Dorsselaer, S., Bak, M., Genetic Risk and Outcome of Psychosis (GROUP) investigators, & van Winkel, R. (2014). Childhood trauma is associated with a specific admixture of affective, anxiety, and psychosis symptoms cutting across traditional diagnostic boundaries. Psychological Medicine, 1-12.
https://doi.org/10.1017/S0033291714002372
Temmingh, H. S., & Stein, D. J. (2015). Anxiety in patients with schizophrenia: epidemiology and management. CNS Drugs, 29(10), 819-832.
https://doi.org/10.1007/s40263-015-0282-7
Tibbo, P., Swainson, J., Chue, P., & LeMelledo, J.-M. (2003). Prevalence and relationship to delusions and hallucinations of anxiety disorders in schizophrenia. Depression and Anxiety, 17(2), 65–72.
https://doi.org/10.1002/da.10083
Wetherell, J. L., Palmer, B. W., Thorp, S. R., Patterson, T. L., Golshan, S., & Jeste, D. V. (2003). Anxiety symptoms and quality of life in middle-aged and older outpatients with schizophrenia and schizoaffective disorder. J Clin Psychiatry 64:12.
https://doi.org/10.4088/jcp.v64n1212
Zarrindast, M.-R., & Khakpai, F. (2015). The modulatory role of dopamine in anxiety-like behavior. Archives of Iranian Medicine, 18(9), 591-603.
Öztürk, S. S., Çiçek, I. E., & Eren, I. (2021). Death anxiety and related factors in schizophrenia patients: Controlled study. OMEGA—Journal of Death and Dying, 0(0), 1–17.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Filip Grajnert, Wiktoria Bińczyk, Olgierd Dróżdż, Bartosz Siudek, Jakub Plizga, Agnieszka Głuszczyk, Mateusz Kamiński, Katarzyna Kuśmierczyk, Patrycja Karkos
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 110
Number of citations: 0