Hierarchical Diagnosis in Chronic Schizophrenia: A Clinical Study of Co-occurring Syndromes

• Published in: Schizophrenia bulletin 2000, Vol.26 (3), p.517-525
• Main Authors: Bermanzohn, Paul C, Porto, Linda, Arlow, Phyllis B, Pollack, Simcha, Stronger, Roslyn, Siris, Samuel G
• Format: Article
• Language: English
• Subjects: Adult; Chronic Disease; Clinical Trials as Topic; Comorbidity; Depressive Disorder, Major - complications; Depressive Disorder, Major - epidemiology; Female; Human; Humans; Major Depression; Male; Obsessive Compulsive Disorder; Obsessive-Compulsive Disorder - complications; Obsessive-Compulsive Disorder - epidemiology; Outpatient; Panic Disorder; Panic Disorder - complications; Panic Disorder - epidemiology; Psychiatric Status Rating Scales; Schizophrenia; Schizophrenia - complications; Schizophrenia - diagnosis; Severity of Illness Index; Syndrome
• ISSN: 0586-7614; 1745-1701
• DOI: 10.1093/oxfordjournals.schbul.a033472

Co-occurring or associated psychiatric syndromes (APS) such as depression, obsessive-compulsive disorder (OCD), and panic disorder have largely been hidden from view by exclusion rules that prohibit their being diagnosed in the presence of schizophrenia. This article presents data from a clinical study of APS in chronic schizophrenia and reviews the relevant literature. Thirty-seven chronic schizophrenia patients consecutively admitted to a day program were administered the Structured Clinical Interview for Diagnosis for DSM-IV and the Yale-Brown Obsessive Compulsive Scale symptom checklist. Exclusion rules prohibiting the diagnosis of APS were bypassed. Eighteen patients (48.6%) had one or more APS. Ten patients (27%) had major depression. Eleven (29.7%) met criteria for OCD. Four patients (10.8%) met criteria for panic disorder. These findings suggest that APS may be common in chronic schizophrenia and that there is a need to study these syndromes' clinical validity, including their treatability. A research plan to study the validity of these syndromes further is discussed.