Measuring anxiety in patients with schizophrenia

This study describes the prevalence and distribution of anxiety symptomatology and anxiety disorders in a sample of hospitalized patients with schizophrenia, the estimated level of agreement between a clinician diagnostic measure and anxiety symptom status measures, and their internal consistency based on the average interitem correlations. Seventy inpatients receiving treatment for schizophrenia were assessed before discharge using a face-to-face diagnostic interview and structured questionnaires, namely the Mini International Neuropsychiatric Interview, the Hospital Anxiety and Depression Scale, the Hamilton Anxiety Scale, the Spielberger Anxiety Inventory, and the Stein Generalized Anxiety Disorder (GAD) Scale. About a quarter of patients met criteria for an anxiety disorder, with GAD and social phobia occurring most commonly. There was poor agreement between the Mini International Neuropsychiatric Interview and a diagnosis of anxiety based on symptom status measures. The Stein GAD scale demonstrated the highest internal consistency (0.85) followed by the Hamilton Anxiety Scale (0.76). Anxiety disorders and anxiety symptomatology are highly prevalent in schizophrenia. Accurate assessment is challenging yet important. More reliable measures of anxiety disorders in patients with schizophrenia and other psychotic disorders are clearly needed to allow for timely identification and treatment.