The Prevalence of Depressive Symptoms in Schizophrenia: A Cross-sectional Study
Abstract
Schizophrenia is a disorder with a highly heterogeneous clinical picture. Depressive symptoms occur in schizophrenia, and they increase the disease burden and distress. There are very few studies on this topic in India. This study aims to estimate the prevalence of depressive symptoms in schizophrenia and its correlation with socio-demographic factors as well as symptom domains such as positive, negative and general psychopathology. This cross-sectional study was conducted in a tertiary care hospital with consecutive sampling. Persons diagnosed with schizophrenia were administered a semi-structured proforma to collect socio-demographic data. Positive and Negative Symptom Scale (PANSS) was administered to assess symptom domains, and The Calgary Depression Scale for schizophrenia (CDSS) was used to measure depressive symptoms. The cut-off score to determine clinically significant depression was fixed at a score >7.
This study found that 28.6 % of persons with schizophrenia had clinically significant depression. It was found that there were no significant differences in age, education, marital status, residence, occupation, or socio-economic class between the depressed and non-depressed groups. 40% of the depressed patients had a positive history of previous suicide attempts, while in the non-depressed group, only 14% had a positive history of prior suicide attempts. In this study, the psychopathology of schizophrenia measured by the PANSS positive scale, negative scale, general psychopathology scale, and the PANSS total score did not have any statistically significant correlation with the depressive symptoms assessed by the Calgary depression scale for schizophrenia. The multidimensional model of schizophrenia gives a valid explanation for the absence of any correlation between depressive symptoms and other psychopathological entities. The clinically significant depression in schizophrenia is probably an independent component rather than a consequence of the psychotic symptomatology. The depressive symptoms should be addressed while treating schizophrenia, and appropriate therapeutic interventions are required to decrease the disease burden and improve the quality of life.
Keywords
Full Text:
PDFReferences
1. Andreasen, N. C. (1982). Negative v Positive Schizophrenia. Archives of General Psychiatry, 39(7), 789. doi: 10.1001/archpsyc.1982.04290070025006
2. Crow, T. J. (1985). The Two-syndrome Concept: Origins and Current Status. Schizophrenia Bulletin, 11(3), 471–488. doi: 10.1093/schbul/11.3.471
3. Arndt, S., Alliger, R. J., & Andreasen, N. C. (1991). The Distinction of Positive and Negative Symptoms. British Journal of Psychiatry, 158(3), 317–322. doi: 10.1192/bjp.158.3.317
4. Lindenmayer, J.-P., Bernstein-Hyman, R., & Grochowski, S. (1994). Five-Factor Model of Schizophrenia Initial Validation. The Journal of Nervous and Mental Disease, 182(11), 631–638. doi: 10.1097/00005053-199411000-00006
5. Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for Schizophrenia. Schizophrenia Bulletin, 13(2), 261–276. doi: 10.1093/schbul/13.2.261
6. Bermanzohn, P. C., Porto, L., Arlow, P. B., Pollack, S., Stronger, R., & Siris, S. G. (2000). At Issue: Hierarchical Diagnosis in Chronic Schizophrenia: A Clinical Study of Co-occurring Syndromes. Schizophrenia Bulletin, 26(3), 517–525. doi: 10.1093/oxfordjournals.schbul.a033472
7. Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for Schizophrenia. Schizophrenia Bulletin, 13(2), 261–276. doi: 10.1093/schbul/13.2.261
8. Serretti, A., Mandelli, L., Lattuada, E., & Smeraldi, E. (2004). Depressive syndrome in major psychoses: a study on 1351 subjects. Psychiatry Research, 127(1–2), 85–99. doi: 10.1016/j.psychres.2003.12.025
9. Häfner, H., Maurer, K., Trendler, G., an der Heiden, W., Schmidt, M., & Könnecke, R. (2005). Schizophrenia and depression: Challenging the paradigm of two separate diseases—A controlled study of schizophrenia, depression and healthy controls. Schizophrenia Research, 77(1), 11–24. doi: 10.1016/j.schres.2005.01.004
10. Kulhara, P., Avasthi, A., Chadda, R., Chandiramani, K., Mattoo, S. K., Kota, S. K., & Joseph, S. (1989). Negative and Depressive Symptoms in Schizophrenia. British Journal of Psychiatry, 154(2), 207–211. doi: 10.1192/bjp.154.2.207
11. Majadas, S., Olivares, J., Galan, J., & Diez, T. (2012). Prevalence of depression and its relationship with other clinical characteristics in a sample of patients with stable schizophrenia. Comprehensive Psychiatry, 53(2), 145–151. doi: 10.1016/j.comppsych.2011.03.009
12. Baynes, D., Mulholland, C., Cooper, S. J., Montgomery, R. C., MacFlynn, G., Lynch, G., Kelly, C., & King, D. J. (2000). Depressive symptoms in stable chronic schizophrenia: prevalence and relationship to psychopathology and treatment. Schizophrenia Research, 45(1–2), 47–56. doi: 10.1016/s0920-9964(99)00205-4
13. Lançon, C., Auquier, P., Reine, G., Bernard, D., & Addington, D. (2001). Relationships between depression and psychotic symptoms of schizophrenia during an acute episode and stable period. Schizophrenia Research, 47(2–3), 135–140. doi: 10.1016/s0920-9964(00)00002-5
14. Emsley, R. A., Oosthuizen, P. P., Joubert, A. F., Roberts, M. C., & Stein, D. J. (1999). Depressive and Anxiety Symptoms in Patients With Schizophrenia and Schizophreniform Disorder. The Journal of Clinical Psychiatry, 60(11), 747–751. 10.4088/jcp.v60n1105
15. Addington, D., Addington, J., & Schissel, B. (1990). A depression rating scale for schizophrenics. Schizophrenia Research, 3(4), 247–251. doi: 10.1016/0920-9964(90)90005-r
16. Zisook, S., McAdams, L. A., Kuck, J., Harris, M. J., Bailey, A., Patterson, T. L., Judd, L. L., & Jeste, D. V. (1999). Depressive Symptoms in Schizophrenia. American Journal of Psychiatry, 156(11), 1736–1743. doi: 10.1176/ajp.156.11.1736
17, Müller, M. J. (2007). Gender-specific associations of depression with positive and negative symptoms in acute schizophrenia. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 31(5), 1095–1100. doi: 10.1016/j.pnpbp.2007.03.014
18. Sands, J. R., & Harrow, M. (1999). Depression During the Longitudinal Course of Schizophrenia. Schizophrenia Bulletin, 25(1), 157–172. doi: 10.1093/oxfordjournals.schbul.a033362
19. Gozdzik-Zelazny, A., Borecki, L., & Pokorski, M. (2011). Depressive symptoms in schizophrenic patients. European Journal of Medical Research, 16(12), 549. doi: 10.1186/2047-783x-16-12-549
20. Siris, S. G. (2000). Depression in Schizophrenia: Perspective in the Era of “Atypical” Antipsychotic Agents. American Journal of Psychiatry, 157(9), 1379–1389. doi: 10.1176/appi.ajp.157.9.1379
Article Metrics
Metrics powered by PLOS ALM
Refbacks
- There are currently no refbacks.
Copyright (c) 2023 Senthilkumaran Chidambaram, Karthik Kaliappan, Lloyds Earnesteen, Jeyaprakash Jeganathan
This work is licensed under a Creative Commons Attribution 4.0 International License.
Email the author