Depressive symptom patterns in patients with chronic schizophrenia and subsyndromal depression
Depressive symptom patterns in patients with chronic schizophrenia and subsyndromal depression
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DOI：
10.1016/j.schres.2006.03.047
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发表时间：
2006-09-01
影响因子：
4.5
通讯作者：
Montross, Lori
中科院分区：
文献类型：
--
作者：
Zisook, Sidney;Nyer, Maren;Montross, Lori
背景：亚综合征抑郁症状在精神分裂症患者和老年患者中普遍存在，对其认识不足且临床意义重大，因此中老年精神分裂症患者与亚综合征抑郁症状的相关性值得进一步研究。本研究的目的是了解慢性精神分裂症或分裂情感性障碍患者亚综合征抑郁症状的死亡发生率、症状模式和相关特征。方法：纳入美国国立卫生研究院RO1#63931《老年精神病患者西妥普兰增强治疗》研究的前165名受试者。纳入标准包括：年龄=40岁，DSM-IV诊断为精神分裂症或分裂情感性障碍，门诊状况；2 MDE的DSM-FV症状和汉密尔顿抑郁量表(HAM-D)评分=8。采用汉密尔顿抑郁量表(HAM-D)的17个条目和卡尔加里抑郁量表(CDRS)对抑郁症状进行评估。结果：抑郁症最常见的症状跨越了抑郁综合征的几个领域：心理(如抑郁情绪、抑郁外表、精神焦虑)；认知(如内疚、绝望、自我贬低、丧失自知力)；躯体(失眠、厌食、性欲减退、躯体焦虑)；精神运动(如迟缓和激动)和功能(工作和活动减少)。被诊断为分裂情感障碍的受试者比被诊断为精神分裂症的患者表现出更多的抑郁，支持更强烈的“内疚参考想法”，并有更高的CDRS总分。结论：本研究证实了根据抑郁亚症状选择的中老年精神分裂症和分裂情感障碍患者抑郁症状的高患病率。(C)2006爱思唯尔B.V.保留所有权利。
Background: Since subsyndromal depressive symptoms (SDS) are prevalent, under-recognized and clinically important problems in patients with schizophrenia, as well as in the elderly, the association and correlates of SDS in mid-life and older age patients with schizophrenia deserves more investigation. The purpose of this study is to learn more about die occurrence, pattern of symptoms and associated features of subsyndromal depressive symptoms in patients with chronic schizophrenia or schizoaffective disorder.Method: The first 165 participants from the "Citalopram Augmentation in Older Adults with Psychoses" (NIH RO1 # 63931) study comprised the sample. Inclusion criteria included: age >= 40, DSM-IV diagnosis of schizophrenia or schizoaffective disorder, outpatient status, > 2 DSM-fV symptoms of MDE and Hamilton Depression Rating Scale (HAM-D) score >= 8. Depressive symptoms were assessed using the 17-item version of the HAM-D and the Calgary Depression Rating Scale (CDRS).Results: The most prevalent symptoms cut across several domains of the depressive syndrome: psychological (e.g., depressed mood, depressed appearance, psychic anxiety); cognitive (e.g., guilt, hopelessness, self depreciation, loss of insight); somatic (insomnia, anorexia, loss of libido, somatic anxiety); psychomotor (e.g., retardation and agitation) and functional (diminished work and activities). Participants diagnosed with schizoaffective disorder appeared more depressed, endorsed more intense "guilty ideas of reference" and had higher total CDRS scores than patients diagnosed with schizophrenia.Conclusion: This study confirms the high prevalence of depressive symptoms in middle-aged and older persons with schizophrenia and schizoaffective disorder who were selected on the basis of having subsyndromal symptoms of depression. (c) 2006 Elsevier B.V All rights reserved.