Social anxiety common in remitted schizophrenia patients

By Mark Cowen, Senior medwireNews Reporter

Social anxiety is common in schizophrenia patients who are in remission and is associated with reduced quality of life, Japanese study results show.

Hiroyuki Kobayashi (Keio University, Tokyo) and team found that although most symptoms improve over time in remitted patients with schizophrenia, social anxiety symptoms often worsen.

"To achieve a complete functional recovery, additional interventions for social anxiety may be needed," they comment in Comprehensive Psychiatry.

The findings come from a 5-year follow-up study of 36 remitted schizophrenia patients who were aged an average of 60.3 years with a mean illness duration of 27.6 years.

All of the participants were assessed at baseline and follow-up using the Liebowitz Social Anxiety Scale (LSAS), the World Health Organization Quality of Life 26 (WHO-QOL26) scale, the Positive and Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning (GAF) scale.

The researchers found that although mean PANSS scores improved and GAF scores remained stable, mean LSAS scores worsened during follow up, increasing from 38.6 to 46.4.

Indeed, 24 (67%) patients had a mean LSAS total score higher than 30 at follow up, suggesting that their social anxiety symptoms had reached a clinical level.

The researchers also found that patients whose LSAS scores worsened over the study period had significantly lower WHO-QOL26 scores at follow up than those whose LSAS scores had remained stable, at 74.4 versus 84.2.

Logistic regression analysis revealed that quality of life at baseline and follow up was negatively associated with social anxiety symptoms.

Kobayashi and team conclude: "The present findings revealed that social anxiety symptoms were commonly reported among elderly patients with remitted schizophrenia after hospital discharge and that the development of social anxiety symptoms was not associated with psychotic symptoms or social functioning, but with subjective quality of life."

They add: "The current study provides a new and important perspective on social anxiety in individuals with schizophrenia."

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