Depressive Symptoms In Schizophrenia Research Articles

Relationships among negative, positive, and depressive symptoms in schizophrenia and psychotic depression.

We examined relationships among positive, negative, and depressive symptoms in schizophrenia and major depression with psychosis. Patients with schizophrenia (n = 17) and major depression and psychotic features (n = 25), with no prior psychopharmacologic treatment were assessed on scales measuring positive psychotic, negative, and depressive symptoms. Analyses revealed the depressive symptoms positively correlated with anhedonia/asociality and avolition/apathy in both patient groups. Positive psychotic symptoms significantly correlated with depressive symptoms in the schizophrenic group. Several specific symptoms used in defining both depressive and negative syndrome constructs appear to be shared. The relationship between positive symptoms and depression in schizophrenia and not psychotic depression suggests the severity of depression may be involved in this relationship.

Depression in first-episode schizophrenia.

Because findings regarding the prognostic significance of depressive symptoms in schizophrenia and their effect on the course and treatment of schizophrenia have been limited by the effects of previous treatment, retrospective evaluations, and differing definitions and criteria, the authors sought to determine the prevalence and prognostic significance of depressive symptoms in first-episode schizophrenia. Thirty-nine men and 31 women experiencing their first episode of schizophrenia were evaluated with behavioral and extra-pyramidal symptom scales before treatment (baseline), biweekly during acute treatment, and then monthly. Extracted scores on the Hamilton Rating Scale for Depression and a "syndromal" definition of depression based on Research Diagnostic Criteria were obtained. Patients were followed prospectively for up to 5 years and received open standardized treatment. The prevalence of depressive symptoms at baseline ranged from 75% (patients who met extracted Hamilton and/or syndromal criteria) to 22% (patients who met both criteria). Of 808 psychotic ratings given to the 70 patients over a 5-year follow-up period, 210 (26%) were concurrently rated as depressed; of the 1,754 nonpsychotic ratings, only 70 (4%) were concurrently rated as depressed. Of the 210 depressive symptoms that occurred concurrently with psychosis, 206 (98%) resolved as the psychosis remitted. Depressive symptoms were prodromal to a psychotic relapse in only two (7%) of 27 patients who relapsed. Depressive symptoms correlated more with positive and negative symptoms than with extrapyramidal symptoms. These findings suggest that depressive symptoms in patients experiencing their first episode of schizophrenia may represent a core part of the acute illness or may occur as a subjective reaction to the experience of psychotic decompensation. Since most of the depressive symptoms resolved as the psychosis remitted, antidepressant therapy should be limited to patients in whom the depression persists.

Depressive symptoms in schizophrenia: a study in hospitalized patients

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Negative and depressive symptoms in schizophrenia.

Ninety-five schizophrenic patients were assessed using the Present State Examination, the Brief Psychiatric Rating Scale and the Scale for the Assessment of Negative Symptoms. Negative and depressive symptoms were frequent, and significant relationships among negative symptom complexes and depressive syndromes were noted. Retardation, lack of energy, slowness, and other symptoms of depression were significantly associated with the negative symptoms of schizophrenia. Depressed affect per se did not have a significant correlation with negative symptoms.

Depressive symptoms in schizophrenia: Comprehensive differential diagnosis

Depression is a common complication of schizophrenia and is associated with increased morbidity and mortality. Contrary to traditional clinical wisdom, depressive symptoms occur during all phases of schizophrenia and are not restricted to the postpsychotic period. In this review, the authors summarize current empirical research and offer a practical approach to the identification of depressive subtypes in schizophrenia. The following subtypes are considered: (1) depressive symptoms occurring secondary to organic factors (caused by medications, substance abuse, or underlying medical problems); (2) nonorganic depressive symptoms occurring with acute psychotic symptoms (intrinsic to the acute psychotic episode or schizoaffective disorder); and (3) nonorganic depressive symptoms occurring without acute psychotic symptoms (prodromal symptoms, negative symptoms, acute dysphoria, secondary depressive syndrome, or chronic demoralization). The authors discuss each of these entities and offer guidelines for diagnosis.

The clinical course of depressive symptoms in schizophrenia

A sample of 31 schizophrenic patients free of anti-psychotic drugs was examined on admission to hospital. 14 (45%) exhibited depressed mood. The course of depressive symptoms and psychotic symptoms was followed weekly while the patients received increasing doses of haloperidol in a standardised regime. In 11 of the 14 patients there was a close correspondence between the course of depressive and psychotic symptoms, suggesting that in these cases, depression was an integral part of the schizophrenic illness. In the other three cases, clinical course of the various symptoms gave some support to the concepts of ‘pharmacogenic’ and ‘post-psychotic depression’, although it was not possible to choose between them.

Observations on the use of depot neuroleptics in schizophrenia.

This paper reviews some of the advantages and disadvantages of long-term maintenance therapy with neuroleptics in schizophrenia. The need to separate first-illness schizophrenia from chronic schizophrenia is illustrated. The reduction in the risk of a further acute relapse with continued medication and the likely duration of maintenance therapy are discussed. The true meaning of a further relapse to the patient in terms of reduced social and work function is also discussed. The advantages of using long-acting depot injections for drug administration are stressed. The complex issue of the correct dosage for maintenance is reviewed, with no proven advantage for either very high doses or very low doses. The frequency of depressive symptoms in schizophrenia is reviewed and the possible aetiologies discussed. The decision to use short- or long-term drug therapy, and whether to use a particular method of drug administration (oral or long-acting depot injections) should be separate issues. Depot injections may, on occasions, be the appropriate method of drug administration for short-term therapies, just as oral drugs have a place in the longer-duration maintenance treatments.