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Anxiety Among College Students with Schizophrenia Spectrum Disorder and Comorbid Neurodevelopmental or Intellectual Conditions

Anxiety Among College Students with Schizophrenia Spectrum Disorder and Comorbid Neurodevelopmental or Intellectual Conditions

Amelia Blanton (1), Anne Thompson (1,2), Cindy Xu (1), Brittany Gouse MD MPH (1,2), Hannah E. Brown MD (1,2)
1: Wellness & Recovery After Psychosis Program, Boston Medical Center, Boston, MA
2: Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA

Background: College students with schizophrenia spectrum disorder (SSD) experience higher dropout rates and difficulties with academic performance compared to those with other psychiatric conditions. Intellectual disabilities and neurodevelopmental disorders (ND) such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are associated with poor social and academic outcomes across age groups. There is a paucity of literature examining the challenges faced by individuals with comorbid SSD and ND or intellectual conditions, particularly among those in the university setting. In this study, we explore the rates of comorbidity between SSD in college students that also have a diagnosis of an ND, and how these combined diagnoses relate to anxiety score and severity.

Methods: We analyzed data from the 2019-2020 Healthy Minds Study (HMS). Students with a history of SSD and a diagnosis of an intellectual disability or ND were included. Students’ reported levels of anxiety were assessed via 4-point Likert scales.

Results: Among 271 included college students with SSD (Mean age: 24.01, 48.1% female, 73.4% white), 24.4% (N=66) reported being diagnosed a neurodevelopmental disorder or intellectual disability. The most reported comorbidity was ADHD (N=55, 20.3%), followed by ASD (N=19, 7%). We found a significant positive correlation between having an ND or intellectual comorbidity and anxiety severity (Spearman’s rho = 0.215, p < 0.001). Furthermore, students with an ND or intellectual comorbidity reported higher levels of anxiety compared to those with SSD alone (23.4% vs. 7.4%, p = 0.002).

Conclusions: These results indicate that students with SSD and an ND or intellectual disability are more likely to experience anxiety and have more severe reported symptoms. Collectively, our findings show a robust relationship between neurodevelopmental and intellectual conditions and anxiety among college students with SSD. Addressing anxiety in this population is crucial for promoting positive mental health outcomes and academic success.