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Schizophrenia Bulletin Advance Access published online on November 14, 2008
Schizophrenia Bulletin, doi:10.1093/schbul/sbn135
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© The Author 2008. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

Psychiatric Comorbidities and Schizophrenia

Peter F. Buckley1,2, Brian J. Miller2, Douglas S. Lehrer3 and David J. Castle4
2 Department of Psychiatry, Medical College of Georgia, 997 St Sebastian Way, Augusta, GA 30912
3 Wright State University Boonshoft School of Medicine and the Wallace-Kettering Neuroscience Institute
4 ST. Vincent's Health and the University of Melbourne

1 To whom correspondence should be addressed; tel: 706-721-6719, e-mail: pbuckley{at}mcg.edu.

Psychiatric comorbidities are common among patients with schizophrenia. Substance abuse comorbidity predominates. Anxiety and depressive symptoms are also very common throughout the course of illness, with an estimated prevalence of 15% for panic disorder, 29% for posttraumatic stress disorder, and 23% for obsessive-compulsive disorder. It is estimated that comorbid depression occurs in 50% of patients, and perhaps (conservatively) 47% of patients also have a lifetime diagnosis of comorbid substance abuse. This article chronicles these associations, examining whether these comorbidities are "more than chance" and might represent (distinct) phenotypes of schizophrenia. Among the anxiety disorders, the evidence at present is most abundant for an association with obsessive-compulsive disorder. Additional studies in newly diagnosed antipsychotic-naive patients and their first-degree relatives and searches for genetic and environmental risk factors are needed to replicate preliminary findings and further investigate these associations.

Keywords: schizophrenia / comorbidity / substance abuse


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