Schizophrenia spectrum disorders with comorbid panic: A systematic review

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Panic disorder comorbidity in schizophrenia spectrum disorders (SSD) is common but poorly understood.
• Classical panic psychosis involves panic anxiety with hallucinations or delusions.
• Clinicians face uncertainty regarding the diagnosis and management of comorbid panic disorder in SSD patients.

Purpose of the Study:

• To describe psychopathological manifestations and pathogenetic factors in schizophrenia spectrum disorders comorbid with panic disorder.
• To highlight the importance of adequate diagnosis and treatment for ameliorating comorbid and psychotic symptoms.

Main Methods:

• Systematic review of studies identified through Medline, LILACS, and Cochrane Library.
• Inclusion of clinical studies with confirmed schizophrenia spectrum disorder diagnoses.
• Evaluation of psychiatric symptomatology using standardized scales for psychosis, panic disorder, anxiety, and general symptoms.

Main Results:

• Twenty-five studies met inclusion criteria from 449 initial results.
• Eleven studies focused specifically on SSD with comorbid Panic Disorder (PD).
• Thirteen studies examined broader SSD groups for panic symptoms.

Conclusions:

• SSD patients with PD comorbidity exhibit more severe psychosis, depression, and suicide ideation, with earlier onset and worse outcomes.
• Panic is correlated with increased depressive symptoms, early onset, and poorer functioning.
• Potential risk factors include early trauma, hypovitaminosis D, and shared familial risk.