Schizophrenia and anxiety have many connections, including higher rates of anxiety disorders in schizophrenics, OCD occasionally predicting schizophrenia, and comorbidity between the two. Treating both disorders is complex, as benzodiazepines can cause side effects and cognitive therapy may be difficult with psychosis present.
There are many connections between schizophrenia spectrum disorders or simply schizophrenia and anxiety. Some of the links noted include that anxiety disorders appear to be higher in schizophrenics than in the general population, that conditions such as obsessive-compulsive disorder (OCD) may occasionally predict schizophrenia, and that the presentation of schizophrenia spectrum disorders or anxiety can complicate the diagnosis. It is also important to distinguish between general concern and concern that some schizophrenic spectrum disorder sufferers may feel about being a part of society which can fuel antisocial behavior and an actual state of anxiety represented by conditions such as generalized anxiety disorder or OCD. .
When the conditions are present together, they are called comorbidities. Review of the medical literature suggests that schizophrenia spectrum disorders and anxiety disorders are common comorbid conditions or large numbers of people who have suffered from schizophrenia may indicate that they previously or currently suffer from anxiety. Some research suggests that one of the strongest connections between schizophrenia and anxiety is that up to half of people diagnosed with schizophrenia spectrum disorders were previously diagnosed with an anxiety disorder. Such studies suggest a related risk factor for people with anxiety disorders.
Similar research finds that OCD, which is classified as an anxiety disorder, appears to have a similar risk. The two illnesses can appear together, or OCD can occur years before the psychosis. One connection between schizophrenia and anxiety disorders such as OCD is that the two diseases may have many characteristics in common, and some doctors believe that OCD should be on the schizophrenia spectrum. Schizophrenics can have highly compulsive behavior that “feels like” OCD, and OCD coercion can feel like schizophrenia. Several studies have evaluated this connection and determined that the comorbidity between schizophrenia spectrum disorders and OCD is approximately 10-25%.
It is difficult to distinguish between schizophrenia and anxiety which could be part of the disease. Features of schizophrenia may include severe distress about disruption to routine and anxiety as a side effect of antipsychotic medications. There may be a blurry line between the “normal” anxiety of schizophrenia and the point at which it transitions into a true disordered state and may require other forms of treatment.
The drugs often used to deal with anxiety, whether or not it is part of a disorder, are the benzodiazepines and these can create more problems by causing sedation, cognitive dullness and drowsiness which are associated with the side effects of antipsychotics. Schizophrenia has a poor medication compliance rate, and additional medications can make some patients more reluctant to take any of their medications. Thus, when schizophrenia and anxiety occur together, treating both disorders is more complex. It may also be more difficult to pursue cognitive therapy treatments for anxiety, which are often the more warranted approach, if psychosis remains present to a large extent.
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