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<p>Severe anxiety and depression are common affective comorbidities in schizophrenia (SZ), yet their relationship with glucose metabolism in early-stage, untreated patients remains unclear. This study investigated the prevalence of severe anxiety (SA), severe depression (SD), and comorbid SA-SD in first-episode antipsychotic-naïve SZ (FEAN-SZ) patients, and explored their associations with glucose metabolism. A total of 321 FEAN-SZ patients and 146 healthy controls were recruited. Demographic data were collected using structured questionnaires. Affective and psychiatric symptoms were assessed with the Hamilton Anxiety Scale (HAMA), the 24-item Hamilton Depression Scale (HAMD-24), and the Positive and Negative Syndrome Scale (PANSS). Glucose metabolism parameters, including fasting glucose, fasting insulin, and insulin resistance (HOMA-IR), were measured. The incidence of SA, SD, and comorbid SA-SD in FEAN-SZ patients was 55.8%, 49.8%, and 42.1%, respectively. Compared to healthy controls, FEAN-SZ patients exhibited significantly higher fasting glucose, insulin levels, and insulin resistance (all <i>p</i><sub><i>s</i></sub> &lt; 0.05). These metabolic abnormalities were more pronounced in patients with SA, SD, and comorbid SA-SD than in those without these symptoms (all <i>p</i><sub><i>s</i></sub> &lt; 0.05). Insulin resistance was independently associated with SA, SD, and comorbid SA-SD (AUC = 0.594–0.633). These findings underscore the importance of metabolic monitoring in SZ patients at illness onset and suggest that glucose metabolism parameters may be associated factors for affective symptomatology.</p>

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Impact of severe anxiety, depression, and their comorbidity on glucose metabolism in first-episode antipsychotic-naïve schizophrenia patients

  • 期刊论文

  • 发表日期：

    2026年5月26日

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  • Chenghao Lu,
  • Yuxin Han,
  • Lijun Wang,
  • Wenjie Sun,
  • Yanzhe Li,
  • Nannan Liu,
  • Shen Li,
  • Jie Li,
  • Xiang Yang Zhang

摘要

Severe anxiety and depression are common affective comorbidities in schizophrenia (SZ), yet their relationship with glucose metabolism in early-stage, untreated patients remains unclear. This study investigated the prevalence of severe anxiety (SA), severe depression (SD), and comorbid SA-SD in first-episode antipsychotic-naïve SZ (FEAN-SZ) patients, and explored their associations with glucose metabolism. A total of 321 FEAN-SZ patients and 146 healthy controls were recruited. Demographic data were collected using structured questionnaires. Affective and psychiatric symptoms were assessed with the Hamilton Anxiety Scale (HAMA), the 24-item Hamilton Depression Scale (HAMD-24), and the Positive and Negative Syndrome Scale (PANSS). Glucose metabolism parameters, including fasting glucose, fasting insulin, and insulin resistance (HOMA-IR), were measured. The incidence of SA, SD, and comorbid SA-SD in FEAN-SZ patients was 55.8%, 49.8%, and 42.1%, respectively. Compared to healthy controls, FEAN-SZ patients exhibited significantly higher fasting glucose, insulin levels, and insulin resistance (all ps < 0.05). These metabolic abnormalities were more pronounced in patients with SA, SD, and comorbid SA-SD than in those without these symptoms (all ps < 0.05). Insulin resistance was independently associated with SA, SD, and comorbid SA-SD (AUC = 0.594–0.633). These findings underscore the importance of metabolic monitoring in SZ patients at illness onset and suggest that glucose metabolism parameters may be associated factors for affective symptomatology.