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Schizophrenia Bulletin 2000 26(3):517-525;
© 2000 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
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© Oxford University Press

At Issue

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

Paul C. Bermanzohn, M.D., Linda Porto, M.S.N., R.N.C., Phyllis B. Arlow, M.S.W., Simcha Pollack, Ph.D., Roslyn Stronger and Samuel G. Siris, M.D.
Medical Director, Queens Day Center, a program of Hillside Hospital/North Shore-Long Island Jewish Health System Jamaica, NY; and Associate Professor of Clinical Psychiatry, Albert Einstein College of Medicine The Bronx, New York
Research Nurse, Department of Research, Hillside Hospital/North Shore-Long Island Jewish Health System
Social Worker at Queens Day Center
Biostatistician, Department of Research, Hillside Hospital/North Shore-Long Island Jewish Health System, when this article was written. He is now Professor of Statistics, Department of Computer Information Systems and Decision Sciences, St. John's University Jamaica, NY
Application Support Specialist, Hillside Hospital/North Shore-Long Island Jewish Health System
Director of Continuing Psychiatric Services for Schizophrenia and Related Disorders, Hillside Hospital/North Shore-Long Island Jewish Health System, and Professor of Psychiatry, Albert Einstein College of Medicine

Send reprint requests to Dr. P.C. Bermanzohn, Queens Day Center, 87-80 Merrick Boulevard, Jamaica, NY 11432; e-mail: bermanzo{at}aecom.yu.edu

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.

Keywords: Schizophrenia / anxiety disorders / depression / obsessive-compulsive disorder / panic disorder / associated psychiatric syndromes / comorbidity


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