Hierarchical diagnosis in chronic schizophrenia: a clinical study of co-occurring syndromes.
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.
Bermanzohn
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PC
Queens Day Center, Jamaica, NY 11432, USA. bermanzo@aecom.yu.edu
Porto
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Arlow
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Pollack
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Stronger
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Siris
S G
SG
D000328:Adult; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000150:complications* / Q000453:epidemiology; D016584:Panic Disorder / Q000150:complications* / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications* / Q000175:diagnosis*; D012720:Severity of Illness Index; D013577:Syndrome