At issue: Hierarchical diagnosis in chronic schizophrenia: A clinical study of co-occurring syndromes

Go-occurring or associated psychiatric syndromes (APS) such as depression, obsessive-compulsive disorder (OCD), and panic disorder have largely been h idden from view by exclusion rules that prohibit their being diagnosed in t he presence of schizophrenia. This article presents data from a clinical st udy of APS in chronic schizophrenia and reviews the relevant literature. Th irty-seven chronic schizophrenia patients consecutively admitted to a day p rogram were administered the Structured Clinical Interview for Diagnosis fo r DSM-IV and the Yale-Brown Obsessive Compulsive Scale symptom checklist. E xclusion rules prohibiting the diagnosis of APS were bypassed. Eighteen pat ients (48.6%) had one or more APS, Ten patients (27%) had major depression, Eleven (29.7%) met criteria for OCD, Four patients (10.8%) met criteria fo r panic disorder. These findings suggest that APS may be common in chronic schizophrenia and that there is a need to study these syndromes' clinical v alidity, including their treatability, A research plan to study the validit y of these syndromes further is discussed.