How should we manage anxiety in patients with schizophrenia?

OBJECTIVE: We aim to provide a selective clinically focused review of the epidemiology, aetiology and management of comorbid anxiety in people with schizophrenia.
METHOD: The following databases were reviewed: PubMed, Medline and Embase.
RESULTS: Anxiety is highly prevalent throughout course of schizophrenia, but is often not identified or its clinical significance is under-appreciated. Also, there is a paucity of rigorous data to support specific treatment guidelines for people with schizophrenia and concurrent anxiety disorders. Psychological treatments such as cognitive behavioural therapy appear effective if targeted carefully, and preliminary data suggest that mindfulness approaches and progressive muscle relaxation may be beneficial. Pharmacological interventions need to be tailored to the individual and target specific symptom sets. There is a growing evidence base about the neurobiology of schizophrenia and concurrent anxiety symptoms or disorders which will hopefully enhance treatment options.
CONCLUSIONS: Further research is required to guide treatment guidelines for anxiety in people with schizophrenia. © The Royal Australian and New Zealand College of Psychiatrists 2015.