Calgary Depression Scale For Schizophrenia Total Score Research Articles

Improving depressive symptoms in patients with schizophrenia using bilateral bipolar-nonbalanced prefrontal tDCS: Results from a double-blind sham-controlled trial

BackgroundTreating depressive symptoms in patients with schizophrenia is challenging. While transcranical Dicrect Current Stimulation (tDCS) improved other core symptoms of schizophrenia, conflicting results have been obtained on depressive symptoms. Thus, we aimed to expand current evidence on tDCS efficacy to improve depressive symptoms in patients with schizophrenia. MethodsA double-blind RCT was performed with patients randomized to 2 mA active-tDCS or sham-tDCS (15 daily sessions) with a bilateral bipolar-nonbalanced prefrontal placement (anode: left Dorsolateral prefrontal cortex; cathode: right orbitofrontal region). Clinical outcomes included variations of Calgary Depression Scale for Schizophrenia total score (CDSS) and of Depression-hopelessness and Guilty idea of reference-pathological guilt factors. Analysis of covariance was performed evaluating between-group changes over time. The presence/absence of probable clinically significant depression was determined when CDSS > 6. ResultsAs 50 outpatients were included (both groups, n = 25), significant improvements following active-tDCS were observed for CDSS total score (p = 0.001), Depression-hopelessness (p = 0.001) and Guilty idea of reference-pathological guilt (p = 0.03). Considering patients with CDSS>6 (n = 23), compared to sham, active-tDCS significantly improved CDSS total score (p < 0.001), Depression-hopelessness (p = 0.001) but Guilty idea of reference-pathological guilt only marginally improved (p = 0.051). Considering response rates of clinically significant depression, important reductions of CDSS score were observed (78 % of the sample scored ≤6; active-tDCS, n = 23; sham-tDCS, n = 16; p = 0.017). Early wakening item did not significantly change in any group. LimitationsThe study lacks a follow-up period and evaluation of tDCS effects on psychosocial functioning. ConclusionsBilateral bipolar-nonbalanced prefrontal tDCS is a successful protocol for the treatment of depressive symptoms in patients with schizophrenia.

Global Improvements and Psychiatric Stability in Adults with Tardive Dyskinesia: Post Hoc Analyses of Two Long-Term Valbenazine Studies (P11-11.010)

Global Improvements and Psychiatric Stability in Adults with Tardive Dyskinesia: Post Hoc Analyses of Two Long-Term Valbenazine Studies (P11-11.010)

Treatment Success and Psychiatric Stability in Adults With Tardive Dyskinesia: Post Hoc Analyses of Two Long-Term Valbenazine Studies

AbstractIntroductionTardive dyskinesia (TD) is a persistent and potentially disabling movement disorder associated with exposure to antipsychotics and other dopamine receptor blocking agents. Effective and comprehensive treatment of TD requires reducing patients’ abnormal involuntary movements without disrupting their psychiatric stability. This can be especially challenging when patients have complex psychiatric conditions (e.g., &gt;1 psychiatric diagnosis) and are taking multiple medications. Valbenazine, a highly potent and selective vesicular monoamine transporter 2 (VMAT2) inhibitor, is approved for the once-daily treatment of TD. This post hoc analysis of two long-term studies (KINECT 3, KINECT 4) was conducted to evaluate changes in psychiatric status and clinician- and patient-reported treatment success in study participants who received valbenazine (40 or 80 mg) for 48 weeks.MethodsData from KINECT 3 and KINECT 4 were pooled and analyzed in participants categorized by their primary psychiatric diagnosis: schizophrenia/schizoaffective disorder (“SCHZ”) or mood disorder (“MD”). Concomitant medications needed for managing these and other psychiatric or medical conditions were allowed. Treatment success was defined as achieving a rating of “much improved” or “very much improved” at Week 48, as assessed using the Clinical Global Impression of Change-Tardive Dyskinesia (CGI-TD) and Patient Global Impression of Change (PGIC). Psychiatric stability was monitored using the following scales: Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) in the SCHZ subgroup; Young Mania Rating Scale (YMRS) and Montgomery-Åsberg Depression Rating Scale (MADRS) in the MD subgroup. Suicidal ideation/behavior was monitored using the Columbia-Suicide Severity Rating Scale.ResultsMore than 75% of study participants in the SCHZ subgroup achieved treatment success with valbenazine, based on clinician assessment (CGI-TD, 79.7%) and patient self-report (PGIC, 78.0%). Mean changes from baseline to Week 48 for PANSS scores (positive symptoms [-0.7], negative symptoms [‑0.6], general psychopathology [-1.9], total [-3.2]) and CDSS total score (-0.5) indicated maintenance of psychiatric stability in the SCHZ subgroup. Similar treatment success rates were found in the MD subgroup for both CGI-TD (77.6%) and PGIC (84.5%), with mean changes from baseline in YMRS total score (-1.0) and MADRS total score (+0.3) indicating psychiatric stability was maintained. No emergence of suicidal ideation/behavior was observed during the studies.ConclusionsPooled analyses from two 48-week studies indicate that long-term treatment of TD with once-daily valbenazine resulted in substantial clinician- and patient-reported global improvements in TD, while psychiatric stability was maintained regardless of primary psychiatric condition.FundingNeurocrine Biosciences, Inc.

Study on risk factors of extrapyramidal symptoms induced by antipsychotics and its correlation with symptoms of schizophrenia

BackgroundExtrapyramidal symptoms (EPS) are one of the most common and neglected side effects during the treatment of schizophrenia. The risk factors of EPS in Chinese patients with schizophrenia and its...

Cognitive deficits, depressive symptoms, insight, and medication adherence in remitted patients with schizophrenia.

Objective:To study the relationship between cognitive deficits, depressive symptoms, insight, and medication adherence in remitted patients with schizophrenia.Methods:Fifty-four patients aged 18–60 years, with schizophrenia in remission, were evaluated for adherence using the Medication Adherence Rating Scale (MARS), cognitive deficits using the Schizophrenia Cognition Rating Scale (SCoRS), depressive symptoms using the Calgary Depression Scale for Schizophrenia (CDSS), and insight using the Beck Cognitive Insight Scale.Results:Twenty-one (38.9%) patients were found to be nonadherent to their medication. A significant negative correlation was found between MARS total score with SCoRS attention/vigilance (r = −0.28), attitude toward negative side effects of the psychotropic medication with SCoRS total score (r = −0.36), SCoRS attention/vigilance (r = −0.27), verbal learning and memory (r = −0.32), reasoning and problem-solving (r = −0.30), and social cognition (r = −0.28). A significant negative correlation was found between CDSS total score with MARS total score (r = −0.50), medication adherence behavior (r = −0.44), and attitude toward negative side effects of psychotropic medication (r = −0.60). MARS total score significantly positively correlated with years in remission (r = 0.29).Conclusions:Poor medication adherence was seen in more than one-third of remitted patients with schizophrenia and was associated with global cognitive deficits, depressive symptoms, and the number of years in remission.

Assessing negative symptoms in schizophrenia: Validity of the clinical assessment interview for negative symptoms in Singapore

This study aimed to examine the validity of the Clinical Assessment Interview for Negative Symptoms (CAINS) in Singapore. 274 participants with schizophrenia were assessed on the CAINS, Scale for the Assessment of Negative Symptoms (SANS), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Social and Occupational Functioning Assessment Scale (SOFAS) and the Simpson-Angus Extrapyramidal Side Effects Scale (SES). Factor analyses were conducted and Cronbach's coefficient alpha was calculated. Spearman's correlation coefficient was used to assess correlations. The 2-factor model of the CAINS failed to fit our data. Exploratory factor analysis of a randomly selected split-half of the sample yielded four factors: motivation-pleasure (MAP) social, MAP vocational, MAP recreational and expression (EXP), accounting for 73.94% of the total variance. Confirmatory factor analysis on the remaining sample supported this factor structure. Cronbach's alpha for the CAINS was 0.770. Significant correlations were observed between the CAINS total and the SANS total and PANSS negative subscale scores. Good divergent validity was shown by insignificant correlations with PANSS positive subscale score and CDSS total score. The MAP social and recreational factor scores had moderate correlations with the SANS anhedonia-asociality subscale scores, whereas the MAP vocational factor had the highest correlation with the avolition-apathy subscale of the SANS. EXP factor score correlated strongly with the SANS affective flattening and alogia subscales scores. In conclusion, the CAINS has good psychometric properties and can be used by clinicians to assess negative symptoms in individuals with schizophrenia in the local population.

Clinical utility of the Calgary Depression Scale for Schizophrenia in individuals at ultra-high risk of psychosis

There is a pressing need for reliable and valid rating scales to assess and measure depression in individuals at ultra-high risk (UHR) of psychosis. The aim of this study was to examine the clinical utility of the Calgary Depression Scale for Schizophrenia (CDSS) in individuals at UHR of psychosis. 167 individuals at UHR of psychosis were included as participants in this study. The Structured Clinical Interview for DSM-IV Axis I Disorders, CDSS, Beck Anxiety Inventory and Global Assessment of Functioning were administered. A receiver operating characteristic (ROC) curve analysis and factor analyses were performed. Cronbach's alpha was computed. Correlations between CDSS factor scores and other clinical variables were examined. The median CDSS total score was 5.0 (IQR 1.0–9.0). The area under ROC curve was 0.886 and Cronbach's alpha was 0.855. A score of 7 on the CDSS yielded the highest sensitivity and specificity in detecting depression in UHR individuals. Exploratory factor analysis of the CDSS yielded two factors: depression-hopelessness and self depreciation-guilt, which was confirmed by confirmatory factor analysis. Further analysis showed that the depression-hopelessness factor predicted functioning; whereas the self depreciation-guilt factor was related to the severity of the attenuated psychotic symptoms. In conclusion, the CDSS demonstrates good psychometric properties when used to evaluate depression in individuals at UHR of psychosis. Our study results also support a two-factor structure of the CDSS in UHR individuals.

A parallel group randomised open blinded evaluation of Acceptance and Commitment Therapy for depression after psychosis: Pilot trial outcomes (ADAPT)

BackgroundDepression is one of the major contributors to poorer quality of life amongst individuals with psychosis and schizophrenia. The study was designed as a Pilot Trial to determine the parameters of a larger, definitive pragmatic multi-centre randomised controlled trial of Acceptance and Commitment Therapy for depression after psychosis (ACTdp) for individuals with a diagnosis of schizophrenia who also meet diagnostic criteria for major depression. MethodsParticipants were required to meet criteria for schizophrenia and major depression. Blinded follow-ups were undertaken at 5-months (end of treatment) and at 10-months (5-months posttreatment). Primary outcomes were depression as measured by the Calgary Depression Scale for Schizophrenia (CDSS) and the Beck Depression Inventory (BDI). ResultsA total of 29 participants were randomised to ACTdp + Standard Care (SC) (n=15) or SC alone (n=14). We did not observe significant differences between groups on the CDSS total score at 5-months (Coeff=−1.43, 95%CI −5.17, 2.32, p=0.45) or at 10-months (Coeff=1.8, 95%CI −2.10, 5.69, p=0.36). In terms of BDI, we noted a statistically significant effect in favour of ACTdp+SC at 5-months (Coeff=−8.38, 95%CI −15.49, −1.27, p=0.02) but not at 10-months (Coeff=−4.85, 95%CI −12.10, 2.39, p=0.18). We also observed significant effects on psychological flexibility at 5-months (Coeff=−8.83, 95%CI −14.94, −2.71, p<0.01) but not 10-months (Coeff=−4.92, 95%CI −11.09, 1.25, p=0.11). ImplicationsIn this first RCT of a psychological therapy with depression as the primary outcome, ACT is a promising intervention for depression in the context of psychosis. A further large-scale definitive randomised controlled trial is required to determine effectiveness.Trial registration: ISRCTN: 33306437

Depressive syndrome in schizophrenia and cannabis use

Introduction Cannabis use is frequently observed in schizophrenia. Several medical and organic factors can lead to this comorbidity. These include depressive symptoms. Objective Assessing the prevalence of depressive symptoms within a population of schizophrenic inpatients and the association with cannabis use. Method A group of 403 patients diagnosed with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), were assessed by The Calgary Depression Scale for Schizophrenia (CDSS) scale measure depressive symptom in schizophrenia. Socio-demographic, clinic, and urine toxicology screens testing data were collected. Results The Schizophrenic patients included in this study have an average age of 33years. The majority of them are males (90%), single (76%) and unemployed (72%). A total of 38 patients (9,4%) have depressive symptoms (scored 6 or more on the CDSS). Among this group, 16 patients (42,1%) were tested positive for cannabis used. Although there is a high proportion of cannabis use among patients with depression symptoms, there was no significant correlation between the CDSS total score and cannabis use among schizophrenic patients. Conclusion Depression is well known to occur during the course of schizophrenia in many patients and contributes substantially to the morbidity. Studies are needed that include correlation analyses between depression and cannabis use in schizophrenia.

Relationship Suicide, Cognitive Functions, and Depression in Patients with Schizophrenia.

The aim of this study was to compare schizophrenic patients with and without a suicide attempt history in terms of sociodemographic and clinical features and cognitive functions and to determine the predictive factors for suicide attempt history. In this study, we assessed and compared 70 patients with schizophrenia, 27 patients with a suicide attempt history, and 43 patients without a suicide attempt history. The cognitive functions of patients were assessed by the Stroop test, Wisconsin Card Sorting Test (WCST), and Rey Auditory Verbal Learning Test. In order to evaluate clinical symptoms, the Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) were used. In this study, the number of hospitalizations, PANSS general psychopathology subscale score, CDSS total score, suicide item score, and WCST total number of responses (WCST1) were significantly higher among the patients with a suicide attempt history. The WCST1 and CDSS total scores were predicted using the suicide attempt history. Revealing the factors related to suicidal behavior in patients with schizophrenia contributes to the prevention of suicide. Studies with long-term follow-up and with a larger sample group are required for the investigation of relationship suicide, cognitive impairment, which is one of the core symptoms of schizophrenia, and depression.

Management of depressive symptoms in schizophrenia.

Although depressive symptoms are a frequently occurring phenomenon in schizophrenia, effective treatments remain an area of clinical need. To assess the benefit of short-term treatment with the atypical antipsychotic asenapine versus placebo on depressive symptoms in patients with acute schizophrenia in an exacerbated state. Data were pooled from intent-to-treat (ITT) populations of three 6-week, randomized controlled studies with fixed doses of asenapine (ASE; n=427), olanzapine (OLA; n=82), risperidone (RIS; n=54), haloperidol (HAL; n=97), or placebo (PLA; n=254). Change from baseline Calgary Depression Scale for Schizophrenia (CDSS) total score and individual item scores were assessed at Day 21 and Day 42 in the total patient population (n=914), and in patients presenting with a CDSS total score of .6 at baseline (n=248). Mixed model repeated measures (MMRM) analyses were performed on patient data. The observed change from baseline in CDSS total score was significantly larger with ASE.compared to PLA.at both Day 21 (p<0.05) and Day 42 (p<0.01) for the total patient population group, and at Day 21 (p<0.05) in patients with baseline CDSS total score .6. For both populations, there was a significant change from baseline in the CDSS depression item score with ASE.compared to PLA.at Day 21 (p<0.01, all patient population; p<0.05, patients with baseline CDSS .6), and at Day 42 (p<0.01) in the all patient population. Statistically significant changes from baseline, in favor of ASE versus PLA, were also observed in other individual CDSS item scores including hopelessness (p<0.05, Day 21, patients with baseline CDSS .6), self-depreciation (p<0.05, Day 42, all patient population), guilty ideas of reference (p<0.01, Day 42, all patient population), pathological guilt (p<0.01, Day 21, all patient population; p<0.05, Day 21 and Day 42, patients with baseline CDSS score .6), and observed depression (p<0.05, Day 21, all patient population). ASE significantly improved a range of depressive symptoms in people with an acute exacerbation of schizophrenia, as measured by the CDSS. ASE may represent a beneficial treatment option for the management of depressive symptoms in patients with schizophrenia.

What are depressive symptoms in acutely ill patients with schizophrenia spectrum disorder?

BackgroundAim was to examine depressive symptoms in acutely ill schizophrenia patients on a single symptom basis and to evaluate their relationship with positive, negative and general psychopathological symptoms. MethodsTwo hundred and seventy-eight patients suffering from a schizophrenia spectrum disorder were analysed within a naturalistic study by the German Research Network on Schizophrenia. Using the Calgary Depression Scale for Schizophrenia (CDSS) depressive symptoms were examined and the Positive and Negative Syndrome Scale (PANSS) was applied to assess positive, negative and general symptoms. Correlation and factor analyses were calculated to detect the underlying structure and relationship of the patient's symptoms. ResultsThe most prevalent depressive symptoms identified were depressed mood (80%), observed depression (62%) and hopelessness (54%). Thirty-nine percent of the patients suffered from depressive symptoms when applying the recommended cut-off of a CDSS total score of >6 points at admission. Negligible correlations were found between depressive and positive symptoms as well as most PANSS negative and global symptoms despite items on depression, guilt and social withdrawal. The factor analysis revealed that the factor loading with the PANSS negative items accounted for most of the data variance followed by a factor with positive symptoms and three depression-associated factors. LimitationsThe naturalistic study design does not allow a sufficient control of study results for the effect of different pharmacological treatments possibly influencing the appearance of depressive symptoms. ConclusionResults suggest that depressive symptoms measured with the CDSS are a discrete symptom domain with only partial overlap with positive or negative symptoms.

Anomalous self-experience and childhood trauma in first-episode schizophrenia

BackgroundAnomalous self-experiences (ASEs) are viewed as core features of schizophrenia. Childhood trauma (CT) has been postulated as a risk factor for developing schizophrenia. AimThe aim of this study is to investigate the relationships between CT, depression and ASEs in schizophrenia. MethodASEs were assessed in 55 patients in the early treated phases of schizophrenia using the Examination of Anomalous Self-Experience (EASE) instrument. Data on CT were collected using the Childhood Trauma Questionnaire, short form (CTQ-SF). This consists of 5 subscales: physical abuse, sexual abuse, emotional abuse, emotional neglect, and physical neglect. Assessment of depression was based on the Calgary Depression Scale for Schizophrenia (CDSS). ResultsWe found significant associations between EASE total score and CTQ total score and between EASE total score and emotional neglect subscore in women, but not men. We also found significant associations between CDSS total score and CTQ total score and between CDSS total score and emotional abuse, emotional neglect, and physical neglect subscores in women, but not men. In men we did not find any significant associations between EASE total score, CDSS total score and any CTQ scores. ConclusionCT was significantly associated with higher levels of ASEs in women in the early treated phases of schizophrenia, but not in men. This again associated with an increase in depressive symptoms.

Reliability and validity of the Calgary Depression Scale for Schizophrenia (CDSS) in youth at clinical high risk for psychosis

Assessment of depression in individuals who are considered to be at clinical high risk (CHR) for psychosis is important as high rates of depression have been reported in CHR individuals. The Calgary Depression Scale (CDSS) is the most widely used scale for assessing depression in schizophrenia. It has excellent psychometric properties, internal consistency, inter-rater reliability, sensitivity, specificity, and discriminant and convergent validity. The aim of this study was to test the reliability and validity of the CDSS in a sample of youth at CHR for psychosis. Participants were assessed for depression, presence of axis 1 mood disorders, and prodromal symptoms using the CDSS, the Structured Clinical Interview for DSM-IV Disorders (SCID-1), and the Scale of Prodromal Symptoms (SOPS). The CDSS total score as well as all individual items, except “guilty ideas of reference,” were significantly associated with the presence of a major depressive disorder. Significant correlations were observed between CDSS total score and the dysphoric mood item on the SOPS. There was some evidence of overlap between the CDSS and both attenuated positive symptoms and negative symptoms as assessed by the SOPS. It is concluded that CDSS is a reliable scale suitable for assessing depression in individuals considered to be at CHR for psychosis.

Prevalence of depression in schizophrenic patients evaluated by the Calgary Depression Scale in Shebin El-Kom, Menoufiya

Middle East Current Psychiatry 2013, 20:191–196 Background Psychiatric comorbidities are communal among patients with schizophrenia. A significant percentage of patients with schizophrenia show depressive symptoms during the development of their illness. Objectives The aim of this study was to evaluate the prevalence of depression using the Calgary Depression Scale for Schizophrenia (CDSS) in a sample of Egyptian patients (Shebin El-Kom, Menoufiya) with schizophrenia and without a diagnosis of depression. Participants In this cross-sectional study, we included outpatients from Menoufiya University Hospital and Shebin El-Kom Educational Hospital, 20–50 years old, with a diagnosis of schizophrenia or schizophreniform disorder that had not been diagnosed with depression. Methodology We administered the CDSS and the Positive and Negative Syndrome Scale (PANSS) to the schizophrenia patient sample. Also, schizophrenia patients were studied according to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. criteria. Results A total of 120 patients were recruited and included in the statistical analysis (72 men and 48 women). Sixty-three patients had a total score of 5 or more points on the CDSS, making the prevalence of depression 30%. The prevalence of depression in men (n = 24) was 33% versus 25% in women (n = 12). There was no significant difference between men and women in terms of the prevalence of depression. The CDSS had a higher correlation with the depressive factor of the PANSS and a moderate correlation with the general psychopathology subscale of the PANSS. Nonetheless, the correlation of the CDSS total score with the PANSS-negative was low. There was no correlation between depressive symptoms and positive symptoms. Conclusion Our results suggest that patients with schizophrenia who have not been diagnosed with depression frequently have clinically symptoms of depression, with the possible exception of a contribution from negative symptoms. CDSS is a more specific instrument to measure depressive symptoms in schizophrenia.

Impact of depressive symptoms on subjective well-being: the importance of patient-reported outcomes in schizophrenia

ObjectiveThe subjective experience of psychotic patients toward treatment is a key factor in medication adherence, quality of life, and clinical outcome. The aim of this study was to assess the subjective well-being in patients with schizophrenia and to examine its relationship with the presence and severity of depressive symptoms.MethodsA multicenter, cross-sectional study was conducted with clinically stable outpatients diagnosed with schizophrenia. The Subjective Well-Being under Neuroleptic Scale – short version (SWN-K) and the Calgary Depression Scale for Schizophrenia (CDSS) were used to gather information on well-being and the presence and severity of depressive symptoms, respectively. Spearman’s rank correlation was used to assess the associations between the SWN-K total score, its five subscales, and the CDSS total score. Discriminative validity was evaluated against that criterion by analysing the area under the curve (AUC).ResultsNinety-seven patients were included in the study. Mean age was 35 years (standard deviation = 10) and 72% were male. Both the total SWN-K scale and its five subscales correlated inversely and significantly with the CDSS total score (P < 0.0001). The highest correlation was observed for the total SWN-K (Spearman’s rank order correlation [rho] = −0.59), being the other correlations: mental functioning (−0.47), social integration (−0.46), emotional regulation (−0.51), physical functioning (−0.48), and self-control (−0.41). A total of 33 patients (34%) were classified as depressed. Total SWN-K showed the highest AUC when discriminating between depressive severity levels (0.84), followed by emotional regulation (0.80), social integration (0.78), physical functioning and self-control (0.77), and mental functioning (0.73). Total SWN-K and its five subscales showed a significant linear trend against CDSS severity levels (P < 0.001).ConclusionThe presence of moderate to severe depressive symptoms was relatively high, and correlated inversely with patients’ subjective well-being. Routine assessment of patient-reported measures in patients with schizophrenia might reduce potential discrepancy between patient and physician assessment, increase therapeutic alliance, and improve outcome.

Prevalence of depression and its relationship with other clinical characteristics in a sample of patients with stable schizophrenia

Aim To evaluate the prevalence of depression using the Calgary Depression Scale for Schizophrenia (CDSS) in a sample of Spanish patients with stable schizophrenia and without a diagnosis of depression. Methods We included stable outpatients of 18 to 50 years of age, with a diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder who had not been diagnosed with depression. In this cross-sectional study, we administered the CDSS, the Positive and Negative Syndrome Scale (PANSS), the Scale for the Assessment of Negative Symptoms (SANS), the Scale to Assess Unawareness of Mental Disorder (SUMD), the Simpson Angus Scale (SAS), and the Barnes Akathisia Rating Scale (BARS). Results A total of 95 patients were recruited, 90 of them were included in the statistical analysis. Twenty-eight patients had a total score of 5 or more points on the CDSS, making the prevalence of depression 31% (95% confidence interval, 22-41). The CDSS had a high correlation with the depressive factor of the PANSS and a moderate correlation with the general psychopathology subscale of the PANSS. The correlation of the CDSS total score with negative symptoms was moderate using the SANS and low with the PANSS-negative. There was no correlation between depressive symptoms and positive symptoms, insight, and extrapyramidal symptoms; and the correlation with akathisia was low. Conclusion Our results suggest that patients with stable schizophrenia who have not been diagnosed with depression frequently have clinically relevant symptoms of depression, and that these symptoms, with the possible exception of a contribution from negative symptoms, are not secondary to other symptoms of their disorder or to extrapyramidal adverse effects of medications.

Depression and subjective quality of life in chronic phase schizophrenic patients.

To evaluate the influence of depression on subjective quality of life in schizophrenic patients. Sixty-seven schizophrenic patients in a stabilized phase were included. Schizophrenic symptoms were evaluated using the Positive and Negative Symptoms Scale (PANSS). The subjective quality of life was evaluated using the short version of the Lehman quality of life scale (QoLI). Depression was evaluated using the Calgary Depression Scale for Schizophrenia (CDSS) and extrapyramidal effects with the Extrapyramidal Symptoms Rating Scale (ESRS). The PANSS total score, PANSS general psychopathology subscore, PANSS depression factor, the total CDSS and some ESRS scores were negatively correlated with the overall life satisfaction score. The CDSS score was negatively correlated with all except one QoLI score. QoLI scores were significantly lower in depressed patients, and this result remained consistent for four QoLi dimensions when adjusted on ESRS and PANSS scores. When analysing the association between high depression scores and high parkinsonism scores with reduced quality of life, multivariate analysis showed that depression was the main explanatory factor: the CDSS total score explained 22% of the variance of the overall subjective quality of life score. The patient questionnaire at the ESRS explained 10.5% of the variance of the 'mental and physical health' QoLI score. In schizophrenic patients, depressive symptoms should be focused because of their strong association to overall subjective quality of life.

Evaluation of depression in schizophrenia: psychometric properties of a French version of the Calgary Depression Scale

The aim of this study was to determine the psychometric properties (especially validity and reliability) of the French language version of the Calgary Depression Scale for Schizophrenia (CDSS) in schizophrenic patients. Ninety-five subjects who met DSM-IV criteria for schizophrenia were enrolled. The studies of the internal structural validity and of the reliability (internal consistency) showed that some items from the CDSS (early awakening and guilty ideas of reference) must be discussed in the constitution of this scale. The total score of the CDSS was significantly correlated with the MADRS total score, the HDRS total score, and the depression item (G6) on the PANSS, which suggests that the CDSS is a valid instrument for the assessment of depression in schizophrenia. The existence of a significant correlation between the CDSS total score and the PANSS positive sub-scale suggests a possible relationship between positive and depressive symptoms in schizophrenia.