I have found that when treating people with psychotic disorders underlying neurotic conditions are of equal importance. Evidence can be found in several research papers of comorbidity of neurotic disorders with psychotic disorders. Rates of around 58% were found in a study by Cassano et al, 1998. This study was published in the journal of clinical psychiatry and is entitled "occurrence and clinical correlates of psychiatric comorbidity in patients with psychotic disorders". This study found the following percentages of comorbidity with psychosis. Panic disorder 24%, ocd 24%, social phobia 17.7%. Other studies have found similar comorbidity and have also found more severe psychopathology in those with comorbid disorders.
My own clinical experience is limitted to the treatment of social phobia and low self esteem in patients with a psychotic diagnosis. This treatment has proved very successful with greatly reduced psychotic symptoms in those treated for these underlying conditions. I would be very interested to hear if any one else has had the same experience.
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