Calgary Depression Scale For Schizophrenia Research Articles

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Background:Depressive symptoms though frequently seen in patients of schizophrenia are often missed. Presence of these symptoms is usually seen to worsen the quality of life in them.Aim:To assess presence of depressive symptoms and quality of life in drug naive cases of schizophrenia.Methods:The study was a hospital based cross sectional study conducted in the Department of Psychiatry, Assam Medical College and Hospital, Dibrugarh, Assam involving 57 consecutive drug naive schizophrenic patients for a period of one year between 18-60 years old. Calgary Depression Scale for Schizophrenia (CDSS) and Quality of Life Scale (QLS) were used as instruments.Results:64.9% of patients in the study were found to have depressive symptoms. The overall mean score for quality of life was found to be 58.93 (SD= 20.51). In patients with depressive symptoms, CDSS mean score was 12.49 (SD=4.51) and quality of life mean score was 47.86 (SD=15.32). The QLS score was significantly correlated with CDSS score (r=-0.91, p<0.0001).ConclusionEarly intervention in depressive symptoms in the schizophrenic patients will improve quality of life amongst such patients.

Validation of a European Spanish adaptation of the Apathy Evaluation Scale-self-rated version (AES-S) in patients with schizophrenia

IntroductionApathy is a negative symptom of schizophrenia and is associated with poor real world functioning. Therefore, it is important to have validated psychometric instruments to assess this symptom. This is the first study to validate the Spanish adaptation of the self-rated version of the Apathy Assessment Scale (AES-S) in patients with schizophrenia. Materials and methodsNaturalistic, cross-sectional, validation study in 104 patients with schizophrenia evaluated using the following scales: Clinical Global Impression-Severity (CGI-S), Personal and Social Performance (PSP), Clinical Assessment Interview for Negative Symptoms (CAINS), Self-report of Negative Symptoms (SNS), Motivation and Pleasure Scale-Self-Report (MAP-SR), Calgary Depression Scale for Schizophrenia (CDSS), and Apathy Evaluation Scale-self-rated version (AES-S). ResultsReliability: Internal consistency (Cronbach's alpha) was 0.908. Convergent validity: The Pearson correlation coefficient between AES-S and CAINS-MAP total scores was −0.483 (p<0.001). For SNS, total and avolition subscale scores were −0.803 and −0.639 (p<0.001), respectively. With the MAP-SR, the correlation coefficient was −0.727 (p<0.001). Divergent validity: The Pearson correlation coefficient between AES-S and PSP total scores was 0.504 (p<0.001). Furthermore, with the CDSS, the correlation coefficient was −0.431 (p<0.001). Discriminant validity: The AES-S discriminated between different levels of illness severity according to CGI-S scores. Factor analysis: A three-component solution explained 57.32% of the variance. Pearson correlations between coefficients were 1–2=0.265, 1–3=0.464, and 2–3=0.060. ConclusionThe Spanish AES-S is a reliable and valid instrument for assessing apathy in Spanish patients with schizophrenia. It seems to be appropriate for use in everyday clinical practice as a means of monitoring apathy in these patients.

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Trans-cranial magnetic stimulation (TMS) can noninvasively modulate specific brain regions to dissipate auditory verbal hallucinations (AVH) in schizophrenia. Citing critical involvement of temporoparietal cortex (TPC) in AVH, we aimed to study the effect of continuous theta burst stimulation (cTBS) targeting bilateral TPC in schizophrenia subjects with AVH, on a randomized rater blinded placebo control trial. 59 patients were randomly allocated to active and sham groups. They received 20 cTBS sessions (2 per day: first right TPC, then left TPC) 5 days a week for 2 weeks. PANSS (Positive and Negative Syndrome Scale), AVHRS (Auditory vocal hallucination rating scale), PSYRAT-AH (Psychiatric symptoms rating scale- Auditory hallucinations scale), CDSS (Calgary depression scale for schizophrenia), SCoRS (Schizophrenia cognition rating scale), CGI-S (Clinical global impression-severity) were assessed at baseline, immediately post 20th session and 2 weeks post-TBS. 50 patients (25-active, 25-sham) completed the study. Conducting an intention to treat analysis, we found a significant group*time effect for PANSS, AVHRS, PSYRAT-AH, CDSS, SCoRS, CGI-S but when controlled for confounding variables, only PANSS-PS (F=26.617, p<0.001), PANSS-TOTAL (F=23.671, p<0.001), AVHRS (F=17.779, p<0.001), PSYRAT-AH (F=11.385, p<0.001) and CGI-S (F=28.462, p<0.001) retained significance. We conclude that cTBS over TPC is safe and has efficacy in AVH in schizophrenia.

The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia.

Suicidal behavior is quite common in schizophrenia and various risk factors for suicide have been reported. The aim of this study was to examine the relationship between suicide attempts and ideation with depression, insight, and internalized stigmatization in patients with schizophrenia. Thirty-six patients with a history of suicide attempts and 52 patients without suicide attempts who were diagnosed as schizophrenia according to DSM-5 diagnostic criteria were included in this study. According to the score which they obtained from the eighth item of the Calgary Depression Scale for Schizophrenia, patients were divided into two groups: not suicidal ideations (zero points) and suicidal ideations (one, two, or three points). Sociodemographic information form, Positive and Negative Syndrome Scale, Calgary Schizophrenia Depression Scale, Schedule for Assessing the Three-Component of Insight, The Internalized Stigma of Mental Illness Scale, and The Suicide Ideation Scale were applied to all of the patients who participated in the study. Patients with suicide attempts were more likely to be single and had higher the Internalized Stigma of Mental Illness Scale scores compared to patients without suicide attempts. Patients with suicidal ideation had higher Positive and Negative Syndrome Scale total scores, higher Calgary Schizophrenia Depression Scale scores, and higher the Internalized Stigma of Mental Illness Scale scores than those without suicidal ideation. There was a strong, positive correlation between the Suicide Ideation Scale and Calgary Schizophrenia Depression Scale, as well as there was a moderate, positive correlation between Positive and Negative Syndrome Scale, the Internalized Stigma of Mental Illness Scale, and the Suicide Ideation Scale in the suicidal ideation group. In regression analysis, depression was found to be a predictor of suicidal ideation. Depression and internalized stigma were risk factors for suicide in schizophrenia. Risk factors need to be carefully assessed to prevent suicide in schizophrenia.

Early trauma and schizophrenia onset: preliminary results of an outpatient cohort in Brazil.

To assess the prevalence of early trauma in individuals with onset of schizophrenia (SZ) at early (≤ 18 years) and adult (> 18 years) ages (EOP and AOP, respectively) and explore relationships between the onset of disease and clinical variables including traumatic events and psychotic and mood symptoms. Subjects with SZ (n = 71) and EOP and AOP were compared for history of psychological trauma, sexual abuse, and physical punishment using the Early Trauma Inventory Self Report - Short Form (ETISR-SF). They were also compared for history of comorbidities and affective disorders using the Diagnostic Interview for Psychosis and Affective Disorders, the Positive and Negative Syndrome Scale, the Liebowitz Social Anxiety Scale, and the Calgary Depression Scale for Schizophrenia. Coefficients were calculated for correlations between scale results and disease duration. Early trauma was significantly associated with an early onset psychotic episode (r = -0.315, p < 0.01). General trauma and depressive symptoms in adulthood were also associated (r = 0.442, p < 0.01), as were social anxiety symptoms and early trauma (r = 0.319, p < 0.01). Total ETISR-SF scores and the physical abuse item were significantly higher in EOP than in AOP. In the hierarchical regression, PANSS scores were best predicted by a model including the duration of disease and age of first psychotic episode (R = 0.303). Our results support the hypothesis that early trauma, including physical abuse, may play a relevant role in schizophrenia symptoms, such as an earlier psychotic occurrence, as well as features of other psychiatric disorders, such as greater severity of social anxiety and depression.

Searching for bridges between psychopathology and real-world functioning in first-episode psychosis: A network analysis from the OPTiMiSE trial.

Network analysis has been used to explore the interplay between psychopathology and functioning in psychosis, but no study has used dedicated statistical techniques to focus on the bridge symptoms connecting these domains. The current study aims to estimate the network of depressive, negative, and positive symptoms, general psychopathology, and real-world functioning in people with first-episode schizophrenia or schizophreniform disorder, focusing on bridge nodes. Baseline data from the OPTiMiSE trial were analyzed. The sample included 446 participants (age 40.0±10.9years, 70% males). The network was estimated with a Gaussian graphical model, using scores on individual items of the positive and negative syndrome scale (PANSS), the Calgary depression scale for schizophrenia, and the personal and social performance scale. Stability, strength centrality, expected influence (EI), predictability, and bridge centrality statistics were computed. The top 20% scoring nodes on bridge strength were selected as bridge nodes. Nodes from different rating scales assessing similar psychopathological and functioning constructs tended to cluster together in the estimated network. The most central nodes (EI) were Delusions, Emotional Withdrawal, Depression, and Depressed Mood. Bridge nodes included Depression, Conceptual Disorganization, Active Social Avoidance, Delusions, Stereotyped Thinking, Poor Impulse Control, Guilty Feelings, Unusual Thought Content, and Hostility. Most of the bridge nodes belonged to the general psychopathology subscale of the PANSS. Depression (G6) was the bridge node with the highest value. The current study provides novel insights for understanding the complex phenotype of psychotic disorders and the mechanisms underlying the development and maintenance of comorbidity and functional impairment after psychosis onset.

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Background:Quality of life (QOL) is considered an important outcome in the treatment of schizophrenia, but the correlates of QOL are poorly understood in this population.Aim:To evaluate the correlates of quality of life in patients with schizophrenia, currently in clinical remission.Methodology:160 patients of schizophrenia in clinical remission were assessed on Self-report Quality of Life Measure, Demoralization Scale, Positive and Negative scale for schizophrenia, Calgary Depression Scale for Schizophrenia, Internalized Stigma of Mental Illness Scale, Everyday discrimination scale, Rosenberg Self esteem Scale, Brief COPE and Brief Dyadic Scale of Expressed Emotions. Appropriate statistical analyses were applied.Results:The mean age of the study sample was 34.99 (SD: 9.13) years. The number of males outnumbered females. Total score on quality of life scale had statistically significant correlation with depression, discrimination, all domains of demoralization, loneliness, stigma, expressed emotions self esteem, maladaptive coping, total coping score and hopelessness.Conclusion:There is a need to routinely evaluate the patients of schizophrenia for quality of life and address various psychological distress to improve quality of life.

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Background:Stigma in mentally ill is considered to be a form of deviance that leads others to judge an individual as not having legitimacy for social participation. Very few studies from India have studied stigma experienced by patients with schizophrenia and its correlates.Aim:To evaluate the correlates of stigma in patients with schizophrenia, currently in clinical remission.Methodology:160 patients of schizophrenia in clinical remission were assessed on Internalized Stigma of Mental Illness Scale, Self-report Quality of Life Measure, Demoralization Scale, Positive and Negative scale for schizophrenia, Calgary Depression Scale for Schizophrenia, Everyday discrimination scale, Rosenberg Self esteem Scale, Brief COPE and Brief Dyadic Scale of Expressed Emotions. Appropriate statistical analyses were applied.Results:The mean age of the study sample was 34.99 (SD: 9.13) years. The number of males outnumbered females. Total score on internalzed stigma of mental illness scale had statistically significant correlation with general psychopathology, depression, discrimination, all domains of demoralization, loneliness, quality of life, expressed emotions, self esteem, maladaptive coping and hopelessness.Conclusion:There is a need to routinely evaluate the patients of schizophrenia for stigma. Better understanding and identification of correlates may suggest ways to reduce stigma and help prevent its adverse consequences.

Relationship between quality of life and clinical factors in inpatients with schizophrenia.

The purpose of this study was to clarify the relationship between quality of life (QOL) and clinical factors in inpatients with schizophrenia. Subjects were 50 hospitalized patients with schizophrenia. Their mean age was 56.48 (Standard Deviation=11.93) years. Japanese version of the schizophrenia Quality of Life Scale (JSQLS) and Subjective Well-being under Neuroleptic drug Treatment Short form, Japanese version (SWNS-J) were used to assess subjective QOL, and Mini Mental State Examination-Japanese was used to evaluate cognitive function. Japanese version of the Calgary Depression Scale for Schizophrenia (JCDSS), Brief Psychiatric Rating Scale, and Drug-Induced Extrapyramidal Symptoms Scale were used to assess depression severity, psychotic symptoms, and drug-induced extrapyramidal symptoms, respectively. Stepwise regression analyses were conducted to find factors influencing JSQLS and SWNS-J. JCDSS was a predictor of two scales of JSQLS, and JCDSS also predicted SWNS-J Total and it's two subscales. However, other clinical factors were not related to JSQLS and SWNS-J. The results indicate that treating depressive symptoms may lead to improvement of subjective QOL in inpatients with schizophrenia. J. Med. Invest. 69 : 80-85, February, 2022.

Eye Movements and Cognitive Functioning in Patients With Schizophrenia Spectrum Disorders: Network Analysis.

Background: Eye movement parameters are often used during cognitive functioning assessments of patients with psychotic spectrum disorders. It is interesting to compare these oculomotor parameters with cognitive functions, as assessed using psychometric cognitive tests. A network analysis is preferable for understanding complex systems; therefore, the aim of this study was to determine the multidimensional relationships that exist between oculomotor reactions and neurocognition in patients with schizophrenia spectrum disorders.Materials and Methods: A total of 134 subjects (93 inpatients with schizophrenia spectrum disorders (ICD-10) and 41 healthy volunteers) participated in this study. Psychiatric symptom severity was assessed using the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, and the Young Mania Rating Scale. Extrapyramidal symptoms were assessed using the Simpson-Angus Scale, and akathisia was assessed using the Barnes Akathisia Rating Scale. Eye movements were recorded using an eye-tracker SMI RED 500, and cognitive function was assessed using the Brief Assessment of Cognition in Schizophrenia. The statistical analyses were conducted using Minitab 17 Statistical Software, version 17.2.1. Data visualization and additional analyses were performed in the R 4.0.3 environment, using RStudio V 1.3.1093 software.Results: A network model of neurocognitive and oculomotor functions was constructed for the patients. In the full network (which includes all correlations) the median antisaccade latency value is the central element of the oculomotor domain, and the Symbol Coding test, the Digit Sequencing test, and the Verbal Fluency test are central elements in the neurocognitive domain. Additionally, there were connections between other cognitive and oculomotor functions, except for the antisaccade error latency in the oculomotor domain and the Token Motor Task in the neurocognitive domain.Conclusion: Network analysis provides measurable criteria for the assessment of neurophysiological and neurocognitive abnormalities in patients with schizophrenic spectrum disorders and allows to select key targets for their management and cognitive remediation.

Exploring low grade inflammation by soluble urokinase plasminogen activator receptor levels in schizophrenia: a sex-dependent association with depressive symptoms

BackgroundThere is evidence of increased low grade inflammation (LGI) in schizophrenia patients. However, the inter-individual variation is large and the association with demographic, somatic and psychiatric factors remains unclear. Our aim was to explore whether levels of the novel LGI marker soluble urokinase plasminogen activator receptor (suPAR) were associated with clinical factors in schizophrenia and if such associations were sex-dependent.MethodIn this observational study a total of 187 participants with schizophrenia (108 males, 79 females) underwent physical examination and assessment with clinical interviews (Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Alcohol Use Disorder Identification Test (AUDIT), and Drug Use Disorder Identification Test (DUDIT)). Blood levels of suPAR, glucose, lipids, and high sensitivity C-reactive protein (hsCRP) were determined and body mass index (BMI) calculated. Multivariable linear regression analyses were used adjusting for confounders, and sex interaction tested in significant variables.ResultsAdjusting for sex, age, current tobacco smoking and BMI, we found that levels of hsCRP and depressive symptoms (CDSS) were positively associated with levels of suPAR (p < 0.001). The association between suPAR and CDSS score was significant in females (p < 0.001) but not in males. Immune activation measured by hsCRP was not associated with depressive symptoms after adjusting for BMI.ConclusionOur findings indicate that increased suPAR levels are associated with depressive symptoms in females with schizophrenia, suggesting aberrant immune activation in this subgroup. Our results warrant further studies, including longitudinal follow-up of suPAR levels in schizophrenia and experimental studies of mechanisms.

Auditory Hallucinations, Depressive Symptoms, and Current Suicidal Ideation or Behavior Among Patients with Acute-episode Schizophrenia

Suicide risk and auditory hallucinations are common in schizophrenia, but less is known about its associations. This cross-sectional study aimed to determine whether the presence and severity of auditory hallucinations were associated with current suicidal ideation or behavior (CSIB) among patients with schizophrenia. We interviewed 299 individuals with schizophrenia and acute symptoms and reviewed their medical records. Measurement included the Psychotic Symptom Rating Scale (PSYRATS-AH), the Calgary Depression Scale for Schizophrenia (CDSS), and the Positive and Negative Syndrome Scale. Logistic regression and path analysis were used. The CSIB prevalence was higher among patients with current auditory hallucination than those without (19.5% vs. 8.6%, crude odds ratio = 2.58, p = .009). Lifetime auditory hallucination experience (adjusted odds ratio [AOR] = 3.81; 95% CI: 1.45–10.05) or current auditory hallucination experience (AOR = 3.22; 95% CI: 1.25–8.28) can elevate the likelihood of CSIB while controlling for depressive symptoms and lifetime suicide-attempt history. Among those with auditory hallucinations, the emotional score of the PSYRATS-AH was positively associated with the CDSS score and there was a small indirect effect of the CDSS score on the association between the emotional domain score and CSIB (bias-corrected 95% CI, 0.02–0.20). In conclusion, the presence of auditory hallucinations was strongly associated with CSIB, independent of depressive symptoms and lifetime suicide attempts. Suicide risk assessment should consider auditory hallucination experience and patients’ appraisal of its emotional characteristics. Future cohort studies are necessary to provide more conclusive evidence for the mediating pathways between auditory hallucinations and CSIB. HIGHLIGHTS The presence of auditory hallucinations was associated with current suicidality. Auditory hallucinations’ emotional severity was related to depressive symptoms. The severity of auditory hallucination was not directly associated with suicidality.

Sex-Specific Effect of Serum Lipids and Body Mass Index on Psychotic Symptoms, a Cross-Sectional Study of First-Episode Psychosis Patients.

Background: Schizophrenia is a disorder with considerable heterogeneity in course and outcomes, which is in part related to the patients' sex. Studies report a link between serum lipids, body mass index (BMI), and therapeutic response. However, the role of sex in these relationships is poorly understood. In a cross-sectional sample of first-episode psychosis (FEP) patients, we investigated if the relationship between serum lipid levels (total cholesterol, HDL-C, LDL-C, and triglycerides), BMI, and symptoms differs between the sexes.Methods: We included 435 FEP patients (males: N = 283, 65%) from the ongoing Thematically Organized Psychosis (TOP) study. Data on clinical status, antipsychotics, lifestyle, serum lipid levels, and BMI were obtained. The Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS) were used to assess psychotic and depressive symptoms. General linear models were employed to examine the relationship between metabolic variables and symptomatology.Results: We observed a female-specific association between serum HDL-C levels and negative symptoms (B = −2.24, p = 0.03) and between triglycerides levels (B = 1.48, p = 0.04) and BMI (B = 0.27, p = 0.001) with depressive symptoms. When controlling for BMI, only the association between serum HDL-C levels and negative symptoms remained significant. Moreover, the HDL-C and BMI associations remained significant after controlling for demography, lifestyle, and illness-related factors.Conclusion: We found a relationship between metabolic factors and psychiatric symptoms in FEP patients that was sex-dependent.

Predictors of unrecognised comorbid depression in patients with schizophrenia at Amanuel mental specialized hospital, Ethiopia: a cross-sectional study

BackgroundThe occurrence of depression in patients with schizophrenia (PWS) increases the risk of relapse, frequency and duration of hospitalisation, and decreases social and occupational functioning.ObjectiveThis study aimed to assess prevalence...

Depression and suicidal ideation in schizophrenia spectrum disorder: a cross-sectional study from a lower middle-income country

Objectives Depression has long been considered a significant feature of schizophrenia and is associated with more frequent psychotic episodes, increased service utilisation, substance misuse, poor quality of life and completed suicide. However, there is a distinct lack of literature on this comorbidity from low- and middle-income countries or non-western cultural backgrounds. Methods This is a cross-sectional analysis of baseline data from a large randomised controlled trial, examining the prevalence of depression and suicidal ideation in patients with schizophrenia spectrum disorder. A total of 298 participants were recruited from inpatient and outpatient psychiatric units in Karachi, Pakistan. Participants completed the Calgary Depression Scale for Schizophrenia (CDSS), Positive and Negative Syndrome Scale (PANSS), Euro Qol (EQ-5D) and Social Functioning Scale (SFS). Results Data indicate that 36% of participants in the study were depressed and 18% endorsed suicidal ideation. Depression was associated with higher positive symptom scores and reduced quality of life, but no significant difference in negative symptoms and social functioning. Conclusions Depression and suicidal ideation are prevalent in Pakistani patients diagnosed with schizophrenia spectrum disorder. Evaluation of depressive symptoms in this group may help identify individuals at higher risk of completed suicide, allowing for targeted interventions to improve outcomes. Key points To our knowledge, this is the first study describing the prevalence of depression and suicidal ideation in individuals with schizophrenia from Pakistan. Our data indicate that 36% of individuals with schizophrenia in our sample were depressed and 18% endorsed suicidal ideation. Depression in schizophrenia was associated with poorer quality of life and higher positive symptom burden. This study adds to the scarce literature from low- and middle-income countries where the burden of mental illness is great and where the majority of suicide deaths occur. Addressing social inequality, food insecurity, high rates of unemployment and low levels of literacy in these settings may have a profound effect on population mental health and suicide risk.

Psychosis and Hopelessness Mediate the Relationship Between Reduced Sleep and Suicidal Ideation in Schizophrenia Spectrum Disorders

Objective Suicide is a major cause of death amongst individuals with schizophrenia spectrum disorders (SSD). Despite numerous risk factors being identified, accurate prediction of suicidality and provision of tailored and effective treatment is difficult. One factor that may warrant particular attention as a contributor to increased psychopathology and suicidality in SSD is disturbed sleep. Sleep disturbances have been reliably linked to greater levels of suicidal ideation and are highly prevalent amongst individuals with SSD. This study aimed to examine if reduced sleep duration and psychopathology are associated with increased suicidal ideation. Method One-hundred and eighteen adults with chronic SSD living within the community participated in this cross-sectional study. Psychosis symptoms were assessed using the Positive and Negative Syndrome Scale. Items 4 and 10 from the Montgomery-Asperg Depression Rating Scale and Item 2 from the Calgary Depression Scale for Schizophrenia were used to assess reduced sleep duration, current suicidal ideation, and hopelessness, respectively. All measures were rated concurrently. Results A hierarchical logistic regression revealed that greater acute sleep disturbances were associated with increased suicidal ideation and this relationship was found to be uniquely mediated by both positive symptom severity and hopelessness. Conclusion These results suggest that individuals with SSD who exhibited disrupted or disordered sleep, positive symptoms and/or hopelessness should be routinely screened for suicidal thinking. Furthermore, interventions that effectively target sleep disruptions may provide much-needed action against suicidal ideation. HIGHLIGHTS Reduced sleep found to be associated with increased suicidal ideation This was uniquely mediated by both hopelessness and positive symptoms More regular screening of sleep problems in schizophrenia is needed

Behavioral outputs of negative symptom domains of schizophrenia.

The present study aimed to validate the hypothesis that negative symptoms of schizophrenia encompass two domains, namely avolition-apathy (AA) and diminished expression (DE), and to investigate the relationship of these domains with behavioral outputs which imply hedonic activities: Cigarette use and weight gain. A total of 106 consecutive schizophrenia outpatients with primary negative symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS), the Negative Symptoms Assessment Scale (NSA-16), the Calgary Depression Scale for Schizophrenia (CDSS), and the Simpson-Angus Scale (SAS). A semi-structured interview was used to assess demographic features, the number of cigarettes smoked per day, and body mass index. Data were analyzed using descriptive statistics, principal component analysis, analysis of variance, and covariance. A two-factor solution was revealed for the negative symptoms of schizophrenia represented by AA and DE. Analyses of variance and covariance suggested that higher AA scores were associated with normal weight and non-smoking status. No significant differences were revealed regarding DE scores in relationship with the same behavioral hedonic outputs. The present results indicated the AA and DE domains exhibit meaningful differences concerning the outcome, which may imply the need for different approaches regarding rating and treatment.

Post-schizophrenia comorbid depressive disorder and insomnia treated by acupuncture combined with Chinese medicine: A retrospective case series based on JBI reporting checklist: 针药并举干预精神分裂症后抑郁共病失眠:一项基于JBI报告清单的回顾性系列病例研究

BackgroundAcupuncture combined with Chinese herbal medicine was performed on 24 patients with post-schizophrenia comorbid depressive disorder and insomnia admitted to the Psychiatry Department, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine from 2016 to 2020, and provided satisfactory results. Considering post-schizophrenia comorbid depressive disorder and insomnia is not a common clinical disorder in hospital of traditional Chinese medicine, the treatment and follow-up cycle is long, and the dropout rate is high, a retrospective case series based on Joanna Briggs Institute (JBI) reporting checklist were conducted instead of a randomized controlled trial. ObjectiveTo retrospectively summary the short-, mid- and long-term effects of acupuncture combined with Chinese herbal medicine for post-schizophrenia comorbid depressive disorder and insomnia, and analyze the principles of the prescriptions. MethodsA retrospective analysis based on case series JBI reporting checklist were performed to investigate effects of 24 patients with post-schizophrenia comorbid depressive disorder and insomnia undergoing 12-week combined acupuncture and Chinese herbal medicine treatment (patients did not receive full dosage treatments, or received western medicine or other physical and psychological therapies during the treatment period were excluded). The psychotic symptoms, depression, insomnia, and self-care ability for daily living were measured by the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Pittsburgh Sleep Quality Index (PSQI), and Activity of Daily Living Questionnaire (ADL-Q), respectively. Follow-ups were conducted at 8 and 16 weeks after treatment. Meanwhile, Acupuncture Beliefs Scale (ABS) was assessed at pre- and post- treatment as well as 16-week follow-up to investigate patients' beliefs and expectations for acupuncture treatment. Results(1) compared with pre-treatment, the PANSS global scores did not decrease significantly at post-treatment and follow-up periods (P> 0.05). (2) compared with pre-treatment, the global scores of CDSS and PSQI decreased significantly at post-treatment and follow-up periods (both P< 0.05). The PSQI global scores at the 16-week follow-up were even significantly lower than at port-treatment (P< 0.05). (3) after treatment, the ADL-Q global scores decreased significantly (P< 0.05), and continued to decrease during the follow-ups (P< 0.05). (4) effective treatment improved patients' beliefs and expectations of acupuncture therapy. ConclusionsAcupuncture combined with Chinese herbal medicine can significantly improve the insomnia and depressed mood following schizophrenia, with satisfactory short-, medium- and long-term effects; effective treatment experience can increase patients' beliefs and expectations for acupuncture therapy.

The role of depression in the prediction of a “late” remission in first-episode psychosis: An analysis of the OPTiMiSE study

ObjectiveThe identification of predictors of psychosis remission could guide early clinical decision-making for treatment of first-episode schizophrenia (FES). MethodsWe analyzed two non-independent subsamples of patients with FES ages 18–40 years from the OPTiMiSE study dataset to investigate the demographic and clinical factors that might help to differentiate “late” remitters (i.e., not in remission at week 2 or 4, but achieving remission within a 10-week follow-up period) from non-remitters within the same period. ResultsSubsample 1 included 216 individuals (55 females, mean age 25.9 years) treated with amisulpride in an open-label design who were not in remission at week 2. Early symptomatic response between baseline and week 2 (odds ratio (OR) = 4.186, 95% confidence interval (CI) = 2.082–8.416, p < 0.001) and older age (OR = 1.081, 95% CI = 1.026–1.138, p = 0.003) were the only variables significantly associated with a higher probability of psychosis remission at week 4. Subsample 2 was composed of the 72 participants (19 females, mean age 25.1 years) who were not in remission at week 4 and completed a 6-week double-blind randomized trial comparing continuation of amisulpride with switch to olanzapine. Depression at baseline (as measured with the Calgary Depression Scale for Schizophrenia) was significantly associated with a nearly 3-fold lower likelihood of psychosis remission during the 10-week follow-up (hazard ratio = 2.865, 95% CI = 1.187–6.916, p = 0.019). ConclusionOur results reinforce the importance of assessing depressive symptoms in people with FES and support the relevance of an early response (as early as 2 weeks) as a predictor of clinical outcome in this population. Clinical trials registrationClinicalTrials.gov identifier: NCT01248195, https://clinicaltrials.gov/ct2/show/NCT01248195.

Exploring depression in adolescents: How depression changes in early onset psychosis (EOP), clinical high risk (UHR) and clinical control (CC) patients

IntroductionDepression is very common in adolescent patients and impacts on their quality of life and functioning. Indeed, depression is an important clinical aspect for treatment, outcome, and prognosis.ObjectivesThis pilot study investigated the factorial structure of the Calgary depression scale for schizophrenia (CDSS) in a sample of help seeking adolescent patients, stratified in three clinical diagnostic subgroups: early onset psychosis (EOP), clinical high risk (UHR) and clinical control (CC). The relationships between these factors and SIPS domains and subjective experiences were also explored.MethodsSixty-nine subjects were examined to assess the severity of depressive symptoms and the degree of subjectively felt cognitive-affective vulnerability (i.e. basic symptoms)ResultsPrincipal component analysis revealed CDSS to include two main factors, namely: “guilty idea of reference-pathological guilt” (factor I), “depression-hopelessness” (factor II). Two factors revealed multiple correlations with SIPS domains and subjective experiences.ConclusionsThe results confirm the dual factorial structure of CDSS previously reported in the literature in adult samples, further increase our knowledge of the psychopathological components of depression in adolescents, and strongly suggest that CDSS can also be used in early diagnostic settingsDisclosureNo significant relationships.