Psychiatr. praxi 2015; 16(1e): e27-e35

Schizophrenia and panic disorder

MUDr. Kristýna Vrbová¹, prof. MUDr. Ján Praško, CSc.¹, Mgr. Marie Ocisková¹, doc. MUDr. Klára Látalová, Ph.D.¹, MUDr. Daniela Jelenová¹

¹ Klinika psychiatrie, Lékařská fakulta Univerzity Palackého v Olomouci, Fakultní nemocnice Olomouc

² Katedra psychologie, Filozofická fakulta Univerzity Palackého v Olomouci

Introduction: Patients with schizophrenia might experience panic attacks and meet the criteria for both schizophrenia and panicdisorder. Classification of mental disorders with hierarchical approach gives schizophrenia the first position before the panic disorder.The panic attacks might not be well recognized and adequately treated. The aim of this study is to determine the prevalence of panicdisorder in schizophrenic patients, to recognise the impact of comorbidity on the clinical picture and the course of the disease, and todetermine the appropriate/possible treatment.

Method: The articles were identified by the keywords “schizophrenia comorbidity” and “panic disorder”, or “agoraphobia”, usingthe Medline and Web of Science search. Additional sources were obtained by studying the references of summaries of importantarticles.

Results: The prevalence of comorbid panic disorder in patients with schizophrenia ranges from 16% to 63%, but the results are notconsistent. Etiopathogenetical hypothesis of schizophrenia and panic disorder and also the concept of panic psychosis are discussed.There is a limited biological evidence to support those hypotheses. Data suggest that patients with schizophrenia and panic disorderexhibit higher rates of depression, suicidal ideation and increased extrapyramidal side effects. Panic comorbidity may worsen severityof positive and negative symptoms of schizophrenia and the overall quality of life.

Conclusion: Panic disorder and schizophrenia often occur comorbid. It is found most commonly in patients with paranoid subtype.Comorbid panic disorder may worsen positive symptoms and lead to depressive symptoms. It negatively affects the quality of lifeand add up to higher level of suicidality. The pharmacotherapy with atypical antipsychotics is preferred, or their combination withclonazepam or alprazolam.

Keywords: schizophrenia comorbidity, panic disorder, agoraphobia

Published: August 1, 2015  Show citation