Comorbidity of Schizophrenia and Social Phobia

Abstract

Introduction The most common comorbid disorder in schizophrenic patients is a social phobia. It is usually an unrecognized problem that may be associated with a high distortion in managing claims of life. Objectives The aim of our study was to determine the extent to which comorbid social phobia affects the severity and course of schizophrenia. Methods The publications were identified in the database medline and web of science using the keywords “schizophrenia comorbidity” in combination with the terms “social phobia” or “social anxiety disorder”. Other relevant sources of information were obtained from the cited works by important articles. Results The current state of research shows that the incidence of comorbid social phobia in psychotic disease states in the range from 11% to 36%. Social phobia in psychotic patients remains largely unrecognized. An untreated social phobia is associated with more severe psychotic symptoms, worse quality of life and lower self-esteem. It also increases the tendency to social isolation and overall worsens social adaptation. Patients with comorbid social phobia and schizophrenia have a higher amount of lifetime suicide attempts and often abuse alcohol or addictive substance. Conclusions Patients who have both schizophrenia and social phobia have a lower quality of life, impaired functioning in life, a higher incidence of suicide attempts and increased risk of relapse of psychosis. It is, therefore, necessary that physicians treating the patients with schizophrenia had in mind the possibility of the presence of comorbid social phobia, and in the case of its occurrence, they also treat it.