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Les troubles dépressifs chez les schizophrènes vus en ambulatoire : Allure sémiologique et problèmes méthodologiques d’évaluation

Published online by Cambridge University Press:  28 April 2020

C. Rodiere-Rein
C. Rodiere-Rein*
Affiliation:
C. Rodière-Rein, Service du Pr Th. Lemperière Hôpital Louis Mourier, 178, rue des Renouillers 92600Colombes - France
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Résumé

Les symptômes d’un groupe de schizophrènes ambulatoires ont été évalués de manière transversale. 95 patients ont été inclus dans une première étude et 87 d’entre eux réévalués un an après.

Les patients étaient considérés comme déprimés quand ils avaient : soit un score égal ou supérieur à 3 à une appréciation clinique globale de la dépression (de score maximum égal à 5), soit un score de 20 ou plus à la M.A.D.R.S.*.

La fréquence de la dépression était de 20 % environ selon les deux modes d’évaluation.

Les patients déprimés avaient aussi la symptomatologie psychiatrique d’ensemble la plus sévère comme en témoignaient leurs scores à la B.P.R.S.*, à l’échelle de schizophrénie extraite de la C.P.R.S.*, et à la check-list d’auto-évaluation S.C.L. 90*.

Les deux modes d’évaluation de la dépression ont paru mesurer deux aspects différents du syndrome : dans la première étude, 20 patients étaient déprimés selon le score clinique global, 20 également selon la M.A.D.R.S., mais 12 seulement selon les deux modes d’évaluation. Comparée au score global, la M.A.D.R.S. paraît retenir des patients dont la pathologie globale et dépressive est plus sévère. Les cliniciens ont hésité à juger cliniquement comme déprimés des malades déficitaires même lorsque leurs profils cliniques avaient par ailleurs une configuration franchement dépressive.

Summary

Summary

Symptoms of depression in a group of schizophrenic outpatients were evaluated in a cross-sectional study. 95 patients were included in a first evaluation and 87 of them reevaluated one year later.

A patient was considered as depressed when he had: (1) a score of 3 or more on the Clinical Global Impression (C.G.I.) scale (maximum score: 5) or (2) a score of 20 or more on the M.A.D.R.S* The incidence of depression was about 20 % in both evaluations.

The depressed patients also had the highest overall scores in terms of psychiatric symptomatology, as seen by scores on the B.P.R.S*, C.P R. S.* schizophrenia sub-scale, and S.C.L. 90*.

When evaluating depression in schizophrenic patients, the C.G.I. and M.A.D.R.S. seemed to measure different aspects of the syndrome. In the first study 20 patients were depressed as measured by the C.G.I. and 20 as measured by the M.A.D.R.S., but only 12 patients met the criteria for depression on both scales. By comparison with the C.G.I., the M.A.D.R.S. seemed to select the most severely depressed patients. Psychiatrists often hesitated to consider patients with negative symptoms as being depressed, despite their clearly depressed clinical profiles.

Type
Research Article
Information
Psychiatry and Psychobiology , Volume 1 , Issue 2 , 1986 , pp. 131 - 138
Copyright
Copyright © European Psychiatric Association 1986

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