Schizophrenia and Panic Disorder

Abstract

Introduction

Patients with schizophrenia mightexperience panic attacks and meet the criteria for both schizophrenia and panicdisorder. Classification of mental disorders with hierarchical approach givesschizophrenia the first position before the panic disorder. The panic attacksmight not be well recognized and adequately treated. The aim of this study isto determine the prevalence of panic disorder in schizophrenic patients, torecognise the impact of comorbidity on the clinical picture and the course ofthe disease, and to determine the appropriate/possible treatment.

Method

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

Results

The prevalence of comorbid panic disorder inpatients with schizophrenia ranges from 16% to 63%, but the results are notconsistent. Etiopathogentical hypothesis of schizophrenia and panic disorderand also the concept of panic psychosis are discussed. There is a limitedbiological evidence to support those hypotheses. Data suggest that patientswith schizophrenia and panic disorder exhibit higher rates of depression, suicidal ideation and increased extrapyramidal side effects. Panic comorbiditymay worsen severity of positive and negative symptoms of schizophrenia and theoverall quality of life.

Conclusion

Panic disorder and schizophreniaoften occurs comorbid. It is found most commonly in patients with paranoidsubtype. Comorbid panic disorder may worsen positive symptoms and lead todepressive symptoms. It negatively affects the quality of life and add up tohigher level of suicidality. The pharmacotherapy with atypical antipsychoticsis preferred, or their combination with clonazepam or alprazolam.