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

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.

Prevalence and clinicians’ awareness of psychiatric comorbidities among first–episode schizophrenia

“…The prevalence of depression in this study was within the range of previous reports on FES (10.4%–34.3%) (Bottlender, Strauss, & Möller, ; Roche et al, ; Wassink, Flaum, Nopoulos, & Andreasen, ). Currently, the aetiology and mechanisms of depressive states in the course of schizophrenia are not well established.…”

A Retrospective Study of the Clinical Characteristics Associated with Alcohol and Cannabis use in Early Phase Psychosis

“…Previous research seems to indicate that alcohol misuse in EPP populations tends to lead to more depression. 51,52 This is mirrored in the general alcohol misuse literature where there is clear evidence of a bidirectional connection between alcohol misuse and depression. 53 One possibility is that our sample size may not have been large enough to detect differences in depression scores between groups.…”

“…Another possibility may be a confounding factor that was not included in our analyses. For example our sample excluded affective psychoses, whereas some previous studies included this group in their population, 51,52 with the possibility that a significant mood component may effect or modulate these results.…”

Depressive psychopathology in first-episode schizophrenia spectrum disorders: a systematic review, meta-analysis and meta-regression

“…Eleven studies comprising 1312 participants examined caseness for depressive disorder according to a cut-off score on severity scales (Addington et al ., 1998; Bendall et al ., 2008; Cotton et al ., 2010; Roche et al ., 2010; Upthegrove et al ., 2010; Riedel et al ., 2012; Chang et al ., 2015; Noto et al ., 2015; Sanchez-Gistau et al ., 2015; Dai et al ., 2017; Herniman et al ., 2017). Four instruments were used: Calgary Depression Rating Scale for Schizophrenia (CDSS), Hamilton Depression Rating Scale (HAM-D), Center for Epidemiological Studies-Depression Scale (CES-D) and CES-D-Revised (CES-D-R) and Montgomery and Åsberg Depression Rating Scale (MADRS).…”