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Prevalence and clinical correlates of depression in the acute phase of first episode schizophrenia

Published online by Cambridge University Press:  13 June 2014

Eric Roche
Affiliation:
Early Intervention in Psychosis Service, Block 5, Blackrock Business Park, Carysfort Avenue, Blackrock, Co Dublin, Ireland
Mary Clarke
Affiliation:
Stanley Research Unit, Dept of Adult Psychiatry, St. John of God Hospitaller Services, Dublin, Ireland and Dept of Psychiatry, School of Medicine, University College Dublin, Ireland
Stephen Browne
Affiliation:
Stanley Research Unit, Dept of Adult Psychiatry, St. John of God Hospitaller Services, Dublin, Ireland
Niall Turner
Affiliation:
Early Intervention in Psychosis Service, Block 5, Blackrock Business Park, Carysfort Avenue, Blackrock, Co Dublin, Ireland
Orflaith McTuige
Affiliation:
Stanley Research Unit, Dept of Adult Psychiatry, St. John of God Hospitaller Services, Dublin, Ireland
Moaayad Kamali
Affiliation:
Stanley Research Unit, Dept of Adult Psychiatry, St. John of God Hospitaller Services, Dublin, Ireland
Anthony Kinsellla
Affiliation:
Early Intervention in Psychosis Service, Block 5, Blackrock Business Park, Carysfort Avenue, Blackrock, Co Dublin, Ireland
Conall Larkin
Affiliation:
Stanley Research Unit, Dept of Adult Psychiatry, St. John of God Hospitaller Services, Dublin and Dept of Psychiatry, School of Medicine, University College Dublin, Ireland
John L Waddington
Affiliation:
Dept. of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2, Ireland
Eadbhard O'Callaghan*
Affiliation:
Early Intervention in Psychosis Service, Stanley Research Unit, Dept of Adult Psychiatry, St. John of God Hospitaller Services and Dept of Psychiatry, School of Medicine, University College Dublin, Ireland
*
*Correspondence E-mail: [email protected]

Abstract

Background: Reported rates of depression in schizophrenia vary considerably.

Objective: To measure the prevalence of depression in a first episode sample of people with schizophrenia.

Methods: All referrals with a first episode of schizophrenia diagnosed using SCID interviews were assessed pre-discharge and again six months later. We used the Calgary Depression Scale for Schizophrenia (CDSS) and Positive and Negative Syndrome Scale (PANSS) to assess the severity of symptoms.

Results: Pre-discharge, 10.4% of the sample met CDSS criteria for depression. According to the PANSS depression (PANSS -D) subscale, 3% of patients were depressed, with a mean score of 7.48 (SD = 2.97). Only 3% of patients pre-discharge were found to be depressed on both the CDSS and the PANSS-D. Six months later 6.5% were depressed according to the CDSS. However none reached depression criteria according to the PANSS-D. The CDSS correlated with PANSS-D both pre-discharge and at follow-up. Feelings of depression and self-deprecation were the most common symptoms at baseline and follow-up. The CDSS was unrelated to negative symptoms at both stages. A lifetime history of alcohol abuse increased the risk for depression.

Conclusion: Rates of depression in this sample were low. The CDSS appears to discriminate between depression and negative symptoms. Like the general population, alcohol misuse is a risk factor for depression in first episode schizophrenia.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2010

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References

1.Collins, A, Remington, G, Coulter, K, Birkett, K. Depression in Schizophrenia: a comparison of three measures. Schizophrenia Res 1996; 20: 205209.CrossRefGoogle ScholarPubMed
2.Hausmann, A, Fleischhacker, W. Differential diagnosis of depressed mood in patients with schizophrenia: a diagnostic algorithm based on a review Acta Psychiatrica Scandinavica 2002; 106(2): 8396.Google Scholar
3.Kim, SW, Kim, SJ, Yoon, BH, Kim, JM, Shin, IS, Hwang, MY, Yoon, JS. Diagnostic validity of assessment scales for depression in patients with schizophrenia. Psychiatry Res 2006; 144(1): 5763.CrossRefGoogle ScholarPubMed
4.Addington, D, Addington, J, Schissel, B. A depression rating scale for schizophrenics. Schizophr Res 1990; 3(4): 247–51.CrossRefGoogle ScholarPubMed
5.Addington, D, Addington, J, Maticka-Tyndale, E, Joyce, J. Reliability and validity of a depression rating scale for schizophrenics. Schizophrenia Res 1992; 6: 201208.CrossRefGoogle ScholarPubMed
6.Addington, D, Addington, J, Patten, S. Depression in people with first-episode schizophrenia. Br J Psychiatry Suppl 1998; 172(33): 90–2.CrossRefGoogle ScholarPubMed
7.Addington, J, Leriger, E, Addington, D. Symptom outcome 1 year after admission to an early psychosis program. Can J Psychiatry 2003; 48(3): 204–7.CrossRefGoogle Scholar
8.Addington, D, Addington, J, Maticka-Tyndale, E. Specificity of the Calgary Depression Scale for schizophrenics. Schizophr Res 1994; 11 (3): 239–44.CrossRefGoogle ScholarPubMed
9.Schuetze, T, Norholm, V, Raabaek Olsen, L, Hougaard, H, Ekstrom, M, Wagn, P, Bech, P. Reliability and validity of the Danish version of the Calgary Depression Scale for Schizophrenia. Nord J Psychiatry 2001; 55(2): 119–22.CrossRefGoogle ScholarPubMed
10.Kontaxakis, VP, Havaki-Kontaxaki, BJ, Margariti, MM, Stamouli, SS, Kollias, CT, Angelopoulos, EK, Christodoulou, GN. The Greek version of the calgary depression scale for schizophrenia. Psychiatry Res 2000; 94(2): 163–71.CrossRefGoogle ScholarPubMed
11.Reine, G, Bernard, D, Auquier, P, Le Fur, B, Lancon, C. Psychometric properties of French version of the Calgary depression scale for schizophrenics (CDSS) Encephale 2000; 26(1): 5261.Google ScholarPubMed
12.Lancon, C, Auquier, P, Reine, G, Bernard, D, Addington, D. Relationships between depression and psychotic symptoms of schizophrenia during an acute episode and stable period. Schizophr Res 2001; 47(2-3): 135–40.CrossRefGoogle ScholarPubMed
13.Whitty, P, Clarke, M, McTigue, O, Browne, S, Gervin, M, Kamali, M, Lane, A, Kinsella, A, Waddington, J, Larkin, C, O'Callaghan, E. Diagnostic specificity and predictors of neurological soft signs in schizophrenia, bipolar disorder and other psychoses over the first four years of illness. Schizophr Res 2006; 86(1-3): 110–7.CrossRefGoogle Scholar
14.Kay, SR, Fiszbein, A, Opler, LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987; 13(2): 261–76.CrossRefGoogle ScholarPubMed
15.Andreasen, NC, Carpenter WT, Jr, Kane, JM, Lasser, RA, Marder, SR, Weinberger, DR. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry 2005; 62(3): 441–9.CrossRefGoogle Scholar
16.Clarke, M, Whitty, P, Browne, S, McTigue, O, Kamali, M, Gervin, M, Kinsella, A, Waddington, JL, Larkin, C, O'Callaghan, E. Untreated illness and outcome of psychosis. Br J Psychiatry 2006; 189: 235–40.CrossRefGoogle ScholarPubMed
17.Spitzer, R. L., Williams, J. B. & Gibbon, J. (1987) Structured Clinical Interview for DSM-III-R – Patient Version (SCID-P). New York: New York State Psychiatric InstituteGoogle Scholar
18.Oosthuizen, P, Emsley, R, Niehaus, D, Koen, L, Chiliza, B. The relationships between depression and remission in first-episode psychosis. World Psychiatry 2006; 5(3): 172–6.Google ScholarPubMed
19.Kamali, M, Kelly, L, Gervin, M, Browne, S, Larkin, C, O'Callaghan, E. Psychopharmacology: insight and comorbid substance misuse and medication compliance among patients with schizophrenia. Psychiatr Serv 2001; 52(2): 161–3.CrossRefGoogle ScholarPubMed
20.Hasin, DSP, Grant, BFP. Major depression in 6050 former drinkers: association with past alcohol dependence. Arch Gen Psychiatry 2002; 59: 794800CrossRefGoogle ScholarPubMed