Prevalence: A recent meta-analysis of more than 4,000 patients found that 38% of patients with schizophrenia suffer from a comorbid anxiety disorder. The most common anxiety disorders are social anxiety disorder (15%), post-traumatic stress disorder (12%), obsessive-compulsive disorder (12%), and 11% for generalized anxiety disorder. One important caveat to keep in mind is that it can be challenging to determine whether anxiety symptoms are a component of the schizophrenia itself or a symptom of a comorbid anxiety disorder.
Treatment: Both psychotherapy (cognitive behavioral therapy; CBT) and medications (selective serotonin reuptake inhibitors; SSRIs) are first-line treatments for patients with anxiety disorders. There is substantial evidence showing that CBT reduces anxiety in patients with schizophrenia. A recent meta-analysis examined 61 studies of CBT for psychosis that all measured social anxiety as a secondary outcome. In addition to moderate reductions in positive and negative symptoms, CBT for psychosis also had a moderate effect (cohen's d = .35) on social anxiety. In contrast, there is very little data about the effectiveness of SSRIs in patients with schizophrenia and comorbid anxiety.