Frequently Asked Questions

Anxiety symptoms were present in 70.6% of the 170 patients with early-phase schizophrenia. The study also noted that about one-third of the sample had moderate to severe daytime anxiety symptoms, indicating that anxiety was common in this clinical population even though its association with schizophrenia severity was weak.

Depressive symptoms were reported in 16.5% of patients with early-phase schizophrenia. Although depression was less prevalent than anxiety in this cohort, it showed a stronger and more clinically meaningful relationship with schizophrenia symptom severity.

The most commonly reported substances were tobacco (31.2%), alcohol (12.9%), cannabis (11.8%), and opioids (5.3%). The study assessed substance involvement risk using the ASSIST tool in 170 patients with schizophrenia of less than 5 years' duration.

Yes, but the association was weak. HAM-A scores were significantly correlated with PANSS total score (ρ=0.219, P=.004), PANSS negative score (ρ=0.174, P=.023), and PANSS general psychopathology score (ρ=0.227, P=.003).

The authors emphasized that these effect sizes were small and likely of limited clinical significance, so anxiety was statistically associated with schizophrenia severity but not strongly enough to be considered a robust clinical marker of overall illness burden in this sample.

Yes. Depressive symptoms showed stronger and more clinically meaningful correlations with schizophrenia severity than anxiety symptoms did. HAM-D scores correlated with PANSS total (ρ=0.394), positive (ρ=0.242), negative (ρ=0.279), and general psychopathology scores (ρ=0.439), with all P<.001.

By comparison, anxiety correlations were weaker at ρ=0.174–0.227. The authors concluded that depression was the more clinically relevant comorbidity in relation to schizophrenia severity in this early-phase cohort.

No. No statistically significant correlation was observed between substance use and PANSS scores for tobacco, alcohol, cannabis, or opioids (all P>.05).

The authors noted that this null finding differed from prior literature and suggested possible explanations within the study context, including the ASSIST tool's focus on substance involvement risk rather than formal substance use disorders, low prevalence of some substances, and exclusion of more severely ill patients.

The findings suggest clinicians should especially prioritize screening for depressive symptoms in early-phase schizophrenia, while also assessing anxiety and substance use as part of integrated care. In this study, depression was present in 16.5% of patients and correlated across all PANSS domains, whereas anxiety was more common at 70.6% but only weakly associated with schizophrenia severity.

The authors specifically supported regular screening with validated tools such as the HAM-D for depression, and they also endorsed routine screening for anxiety and substance use to support comprehensive treatment planning.

No observed extrapyramidal symptoms were reported in this sample. All 170 participants had an AIMS score of 0.

The authors cautioned that this likely reflected the study's prescreening process, which screened out patients with significant extrapyramidal symptoms, as well as the fact that all participants were receiving atypical antipsychotics, which generally have a lower risk of extrapyramidal symptoms.

This was a cross-sectional observational study conducted in a tertiary care hospital in Northern India. It included 170 adults aged 18–60 years with ICD-11 schizophrenia and illness duration of less than 5 years, and data were collected over 18 months from November 2023 to May 2025.

The study used PANSS for schizophrenia severity, HAM-A for anxiety symptoms, HAM-D for depressive symptoms, ASSIST for substance involvement risk, and AIMS for extrapyramidal symptoms.

The main limitations were that the study was cross-sectional, did not account for medication history in the analyses, lacked longitudinal follow-up, and was conducted at a single tertiary care center in North India. Because of the cross-sectional design, the authors stated that causal inference cannot be made and temporal relationships between schizophrenia severity and comorbid symptoms remain unclear.

The authors also noted that ongoing treatment with antipsychotics, antidepressants, or anxiolytics could have influenced PANSS, HAM-A, and HAM-D scores, and that generalizability to other settings or populations may be limited.