Social Anxiety Can Linger After Recovery

Even if individuals with schizophrenia manage to throw off the yoke of positive and negative symptoms, they may still fear fitting into society.

In a study of some 80 outpatients with schizophrenia who had recovered partially or totally from their illness, 36 percent were found to suffer from social anxiety disorder, Stefano Pallanti, M.D., of the Institute of Neurosciences in Florence, Italy, and colleagues found. Further, no differences in negative and positive symptoms were discovered between those subjects who experienced social anxiety and those who did not.

Thus, “social anxiety is a highly prevalent, disabling condition in outpatients with schizophrenia that is unrelated to clinical psychotic symptoms,” Pallanti and his coworkers concluded in the January American Journal of Psychiatry.

The subjects who were socially anxious had symptoms of that condition that were as severe as those in 27 individuals who had social anxiety disorder as a primary diagnosis, the researchers learned. Finally, subjects who had both schizophrenia and a phobia about interacting with other people had a lower quality of life and a higher rate of suicide attempts than did those subjects who had schizophrenia without social anxiety.

“If these observations are confirmed by further studies in larger samples,” the researchers wrote in their study report, “adequate. . . treatments will need to be sought. Currently there are no operational guidelines for the treatment of comorbid social anxiety disorder in schizophrenia.”

The study, “Social Anxiety in Outpatients With Schizophrenia: A Relevant Cause of Disability,” is posted online at http://ajp.psychiatryonline.org/cgi/content/full/161/1/53?. ▪

Am J Psychiatry 2004 161 53