Depressive symptoms in first episode schizophrenia spectrum disorder

• Published in: Schizophrenia research Vol. 134; no. 1; pp. 20 - 26
• Main Authors: Cotton, S.M, Lambert, M, Schimmelmann, B.G, Mackinnon, A, Gleeson, J.F.M, Berk, M, Hides, L, Chanen, A, McGorry, P.D, Conus, P
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.01.2012; Elsevier
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Australia; Biological and medical sciences; Case-Control Studies; Depression; Depression - complications; Depression - epidemiology; Depressive Disorder, Major - complications; Depressive Disorder, Major - epidemiology; Early psychosis; Female; First episode schizophrenia; Humans; Male; Medical sciences; Mood; Mood disorders; Outcome; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Psychotic Disorders - complications; Schizophrenia; Schizophrenia - complications; Schizophrenia - physiopathology; Substance-Related Disorders - epidemiology; Treatment; Australia; Depression; Early psychosis; Mood; Treatment; Outcome; First episode schizophrenia; Mood disorder; Human; Affect affectivity; Schizophrenia; Psychosis; Symptomatology; First episode; Early
• ISSN: 0920-9964; 1573-2509
• DOI: 10.1016/j.schres.2011.08.018

Abstract Background Depressive symptoms in ‘non-affective’ first episode schizophrenia spectrum disorders (FES) are common, but poorly understood, resulting in a range of conceptual and clinical management issues. This study had three aims: (i) to determine the prevalence of moderate to severe depressive symptoms (defined as a Clinical Global Impressions Scale-Bipolar Disorder (CGI-BP depression) score > 3) in a large representative sample of FES patients; (ii) to compare the clinical and functional characteristics of FES patients with and without these depressive symptoms at service entry; and (iii) to compare the characteristics of FES patients with and without persistent depressive symptoms. Methods Medical file audit methodology was employed to collect information on 405 patients with FES treated at the Early Psychosis Prevention and Intervention Centre (EPPIC), Melbourne, Australia. Results 26.2% (n = 106) of the patients had moderate to severe depression at service entry. At service entry and at discharge, those with depressive symptoms had greater insight into their illness but did not differ from those without depressive symptoms in terms of severity of overall psychopathology. Substance use was significantly less common in those with depressive symptoms at service entry and at discharge. Of those who were depressed at baseline, 14.2% (n = 15) continued to have moderate to severe depressive symptoms at discharge. Discussion Depressive symptoms are common in patients with FES. Understanding the nature and characteristics of depression in FES has important clinical implications for both early intervention and treatment.