Prevalence rate of social anxiety disorder in individuals with a psychotic disorder: A systematic review and meta-analysis

Social anxiety disorder (SAD) is characterised as an excessive fear of negative judgment from others and is considered one of the most disabling of the mental ill health conditions. Research findings indicate that it is also a significant issue for individuals diagnosed with a psychotic disorder, with prevalence rates of social anxiety ranging from 8% to 36%. This study was conducted to address the variance of the reported prevalence rates of comorbid SAD amongst individuals with a psychotic disorder diagnosis. Via a systematic review, we collated all available literature on the prevalence of SAD in individuals with a psychotic disorder, and evaluated the prevalence results via meta-analysis. We also synthesised all psychosocial outcomes attributed to SAD comorbidity and conducted a narrative review of the relevant findings. Across 25 studies providing data from 1980 to May 2018 and spanning 13 countries (N = 92,522), we found a pooled prevalence rate of 21% (16%-26%). In outpatient samples, (17 studies), the prevalence was 25% (19%-31%), statistically significantly higher (z = 5.12, p < .001) than that of the inpatient studies six studies, which was 9% (7%-12%). We also found that SAD comorbidity is associated with increased depression, poorer social function, poorer subjective quality of life, greater negative self-evaluation, and greater insight. The results from this systematic review and meta-analysis suggest that SAD is prevalent amongst individuals with a psychotic disorder. More consistent screening for SAD and the development of theoretically driven and empirically supported tailored treatments are recommended. (C) 2019 Elsevier B.V. All rights reserved.