Obsessive-compulsive and panic symptoms in patients with first-admission psychosis.
OBJECTIVE
The occurrence, persistence and specificity of the association between comorbid obsessive-compulsive and panic symptoms and three psychotic disorders--schizophrenia/schizoaffective disorder, bipolar disorder with psychosis, and major depression with psychosis--were examined in a first-admission, epidemiologically defined group of patients with psychotic symptoms.


METHODS
The Structured Clinical Interview for DSM-III-R obsessive-compulsive and panic modules were administered at baseline and 24-month follow-up to patients with schizophrenia/schizoaffective disorder (N=225), bipolar disorder with psychosis (N=138), and major depression with psychosis (N=87) participating in the Suffolk County (N.Y.) Mental Health Project. The rates of subsyndromal symptoms and disorder criteria met were compared across the three psychosis groups. Recognition and treatment of anxiety symptoms at initial discharge and impact of the baseline presence of anxiety symptoms on 24-month clinical status were also examined.


RESULTS
Obsessive-compulsive and panic symptoms were present at baseline in 10%-20% of all three groups. There was no specific association between obsessive-compulsive symptoms and any specific psychosis diagnosis; however, women with major depression with psychosis had a significantly higher rate of panic symptoms than the other two groups, and schizophrenia/schizoaffective disorder patients with baseline panic symptoms were significantly more likely to exhibit positive symptoms of psychosis after 24 months.


CONCLUSIONS
The authors found no specific association between obsessive-compulsive symptoms and diagnosis early in the illness course, but the finding of an association between panic symptoms and psychotic depression among female patients and between baseline panic and positive psychotic symptoms in schizophrenia/schizoaffective disorder patients at 24 months suggests the need for further study.
Craig
Thomas
T
VA Office of Quality and Performance, Washington, DC, USA. thomas.craig@mail.va.gov
Hwang
Michael Y
MY
Bromet
Evelyn J
EJ
D000328:Adult; D000367:Age Factors; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D016584:Panic Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D010343:Patient Admission; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology; D012565:Schizophrenic Psychology; D012737:Sex Factors; D016896:Treatment Outcome