Depressive symptoms among patients with schizophrenia in acute and remission phases

Bacground/Aim. Researchers suggest that among people with schizophrenia, the prevalence of depressive symptoms ranges from 7% to 80%. The rate of depressive symptoms among people with schizophrenia varies widely because of the phase of the disease, type of study applied, rating scale for depressive symptoms and diagnostic criteria. The aim of this research was to determine the prevalence of depressive symptoms and the clinical correlation of depressive symptoms with other clinical parameters (type and severity of psychotic symptoms, severity of illness, insight and global functioning) among patients with schizophrenia in acute and remission phases. Methods. This prospective clinical study enrolled 100 consecutive patients with schizophrenia both in acute and remission phases. Psychometric assessments were made using the Positive and Negative Syndrome Scale (PANSS) for rating the symptoms of schizophrenia, Scale to Assess the Unawareness of Mental Disorder (SUMD), Calgary Depression Scale for Schizophrenia (CDSS), and Global Assessment of Functioning Scale. Results. The prevalence of depressive symptoms among patients with schizophrenia in the acute phase was 23% at the study group, while in the remission phase it was 13%. In the acute phase, the CDSS scale correlated with a depressive and positive subscale of the PANSS scale as well as SUMD scale. In the remission phase, the CDSS scale correlated only with a depressive subscale of the PANSS scale. The CDSS scale did not correlate with the negative subscale of the PANSS scale. The subjective nature of depressive symptoms is more pronounced in the remission phase. Conclusion. Our findings showed that depressive symptoms were more pronounced in the acute psychotic phase than in the remission phase of schizophrenia. Targeted, patient oriented, and algorithm-based approach for treatment management, with taking into account different phenotypic expressions of the disorder (patients with and without affective symptoms) is warranted in patients with schizophrenia.

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Prevalence and Influencing Factors of Anxiety and Depression Symptoms Amongst Surgical Nurses During COVID-19 Pandemic: A Large-Scale Cross-Sectional Study

10.21203/rs.3.rs-125116/v1 ◽

2020 ◽

Author(s):

Chun-Xia Ren ◽

De-Cun Zhou ◽

Yin-Guang Fan ◽

Bao-Zhu Li ◽

Wan-Fei Zhang ◽

...

Keyword(s):

Social Support ◽

Depressive Symptoms ◽

Influencing Factors ◽

Rating Scale ◽

Depression Scale ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Cross Sectional ◽

Self Rating ◽

Surgical Nurses

Abstract BackgroundThe outbreak of novel 2019 coronavirus disease (COVID-19) has imposed an enormous physical and psychological pressure on people across the world. This study focused on evaluating the prevalence and influencing factors of anxiety and depression symptoms in surgical nurses during the epidemic in China. MethodA cross-sectional, multicenter quantitative study was conducted in Anhui province (China) from March 3, 2020 to March 19, 2020, with a questionnaire package which consisted of general information questionnaire，Zung's self-rating anxiety scale (SAS), Zung's self-rating Depression Scale (SDS) and social support rating scale (SSRS). A total of 3600 surgical nurses participated in the survey by Wechat and QQ. Data were analysed using multiple linear regression models. ResultsA total of 3492 surgical nurses from 12tertiary hospitals and 12 secondary hospitals in one province of mainland China completed the survey. The prevalence rates of anxiety symptoms and depressive symptoms were 24.83% and 22.39%, respectively. The average level of anxiety and depression of surgical nurses were higher than that of the Chinese norm (P< 0.05).Levels of social support for surgical nurses were significantly negatively associated with the degree of anxiety (r = -0.630, P < 0.001) and depression (r = -0.578, P < 0.001). Fertility status (β = 1.469, P = 0.003), hospital (β = -0.611, P < 0.001), participation in care for COVID-19 patients (β = 2.229, P < 0.001), likelihood of being infected with COVID-19 (β = 1.146, P < 0.001), social support (β = -0.623, P < 0.001) were significantly influencing surgical nurses’ anxiety degree. Similarly, these characteristics were significantly associated with the odds of experiencing depression symptoms in surgical nurses. Divorce and widowed surgical nurses (β = -2.654, P < 0.001) were significantly more likely to experience depressive symptoms than single nurses. ConclusionIn this survey, we found that the surgical nurses had high anxiety and depression symptoms during the COVID-19 outbreak in China. The findings suggest that targeted psychological interventions to promote the mental health of surgical nurses with psychological problems need to be immediately implemented.

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Relationship Between Frailty and Depression Among Community-Dwelling Older Adults: The Mediating and Moderating Role of Social Support

The Gerontologist ◽

10.1093/geront/gnaa072 ◽

2020 ◽

Vol 60 (8) ◽

pp. 1466-1475 ◽

Cited By ~ 1

Author(s):

Yaru Jin ◽

Huaxin Si ◽

Xiaoxia Qiao ◽

Xiaoyu Tian ◽

Xinyi Liu ◽

...

Keyword(s):

Social Support ◽

Older Adults ◽

Depressive Symptoms ◽

Rating Scale ◽

Depression Scale ◽

Community Dwelling ◽

Linear Regression Models ◽

Frailty Phenotype ◽

Community Dwelling Older Adults ◽

The Relationship

Abstract Background and Objectives Frailty is associated with depression in older adults and reduces their social support. However, the mechanism underlying such relationship remains unclear. We aim to examine whether social support acts as a mediator or moderator in the relationship between frailty and depression. Research Design and Methods This cross-sectional study was conducted among 1,779 community-dwelling older adults aged 60 and older. Frailty, social support, and depressive symptoms were measured by the Physical Frailty Phenotype, Social Support Rating Scale, and five-item Geriatric Depression Scale, respectively. Data were also collected on age, gender, years of schooling, monthly income, cognitive function, number of chronic diseases, physical function, and pain. Results Linear regression models showed that subjective support and support utilization, but not objective support, mediated and moderated the relationship between frailty and depressive symptoms. The Johnson–Neyman technique determined a threshold of 30 for subjective support, but not for support utilization, beyond which the detrimental effect of frailty on depressive symptoms was offset. Discussion and Implications Social support underlies the association of frailty with depression, and its protective role varies by type. Interventions on depression should address improving perceptions and utilization of social support among frail older adults rather than simply providing them with objective support.

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Effects of bright light therapy for depression during pregnancy: a randomised, double-blind controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-038030 ◽

2020 ◽

Vol 10 (10) ◽

pp. e038030

Author(s):

Babette Bais ◽

Astrid M Kamperman ◽

Hilmar H Bijma ◽

Witte JG Hoogendijk ◽

Jan L Souman ◽

...

Keyword(s):

Depressive Symptoms ◽

Pregnant Women ◽

Rating Scale ◽

Controlled Trial ◽

Depression Scale ◽

Bright Light ◽

Light Therapy ◽

Secondary Outcome ◽

Bright Light Therapy ◽

Double Blind

ObjectivesApproximately 11%–13% of pregnant women suffer from depression. Bright light therapy (BLT) is a promising treatment, combining direct availability, sufficient efficacy, low costs and high safety for both mother and child. Here, we examined the effects of BLT on depression during pregnancy.DesignRandomised, double-blind controlled trial.SettingPrimary and secondary care in The Netherlands, from November 2016 to March 2019.Participants67 pregnant women (12–32 weeks gestational age) with a DSM-5 diagnosis of depressive disorder (Diagnostic and Statistical Manual of Mental Disorders).InterventionsParticipants were randomly allocated to treatment with either BLT (9000 lux, 5000 K) or dim red light therapy (DRLT, 100 lux, 2700 K), which is considered placebo. For 6 weeks, both groups were treated daily at home for 30 min on awakening. Follow-up took place weekly during the intervention, after 6 weeks of therapy, 3 and 10 weeks after treatment and 2 months postpartum.Primary and secondary outcome measuresDepressive symptoms were measured primarily with the Structured Interview Guide for the Hamilton Depression Scale—Seasonal Affective Disorder. Secondary measures were the Hamilton Rating Scale for Depression and the Edinburgh Postnatal Depression Scale. Changes in rating scale scores of these questionnaires over time were analysed using generalised linear mixed models.ResultsMedian depression scores decreased by 40.6%–53.1% in the BLT group and by 50.9%–66.7% in the DRLT group. We found no statistically significant difference in symptom change scores between BLT and DRLT. Sensitivity and post-hoc analyses did not change our findings.ConclusionsDepressive symptoms of pregnant women with depression improved in both treatment arms. More research is necessary to determine whether these responses represent true treatment effects, non-specific treatment responses, placebo effects or a combination hereof.Trial registration numberNTR5476.

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Depressive Symptoms, Pain, and Quality of Life among Patients with Nonalcohol-Related Chronic Pancreatitis

Pain Research and Treatment ◽

10.1155/2012/978646 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Wendy E. Balliet ◽

Shenelle Edwards-Hampton ◽

Jeffery J. Borckardt ◽

Katherine Morgan ◽

David Adams ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Pancreatitis ◽

Depressive Symptoms ◽

Rating Scale ◽

Depression Scale ◽

Self Report ◽

Cross Sectional ◽

Depressive Symptomology ◽

The Mean

Objective. The present study was conducted to determine if depressive symptoms were associated with variability in pain perception and quality of life among patients with nonalcohol-related chronic pancreatitis. Methods. The research design was cross-sectional, and self-report data was collected from 692 patients with nonalcohol-related, intractable pancreatitis. The mean age of the sample was 52.6 (); 41% of the sample were male. Participants completed the MOS SF12 Quality of Life Measure, the Center for Epidemiological Studies 10-item Depression Scale (CESD), and a numeric rating scale measure of “pain on average” from the Brief Pain Inventory. Results. Depressive symptoms were significantly related to participants’ reports of increased pain and decreased quality of life. The mean CESD score of the sample was 10.6 () and 52% of the sample scored above the clinical cutoff for the presence of significant depressive symptomology. Patients scoring above the clinical cutoff on the depression screening measure rated their pain as significantly higher than those below the cutoff () and had significantly lower physical quality of life () and lower mental quality of life (). Conclusion. Although causality cannot be determined based on cross-sectional, correlational data, findings suggest that among patients with nonalcoholic pancreatitis, the presence of depressive symptoms is common and may be a risk factor associated with increased pain and decreased quality of life. Thus, routine screening for depressive symptomology among patients with nonalcoholic pancreatitis may be warranted.

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Effect of vitamin D supplement on depression scores in people with low levels of serum 25-hydroxyvitamin D: nested case—control study and randomised clinical trial

The British Journal of Psychiatry ◽

10.1192/bjp.bp.111.104349 ◽

2012 ◽

Vol 201 (5) ◽

pp. 360-368 ◽

Cited By ~ 108

Author(s):

Marie Kjærgaard ◽

Knut Waterloo ◽

Catharina E. A. Wang ◽

Bjørg Almås ◽

Yngve Figenschau ◽

...

Keyword(s):

Vitamin D ◽

Depressive Symptoms ◽

Rating Scale ◽

Seasonal Pattern ◽

Depression Scale ◽

High Serum ◽

High Dose ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Low Levels

AimsTo compare depressive symptoms in participants with low and high serum 25-hydroxyvitamin D (25(OH)D) levels and to examine whether supplementation with vitamin D3 would improve symptoms in those with low serum 25(OH)D levels.MethodParticipants with low 25(OH)D levels were randomised to either placebo or 40 000 IU vitamin D3 per week for 6 months. Individuals with high serum 25(OH)D levels were used as nested controls. Depressive symptoms were evaluated with the Beck Depression Inventory, Hospital Anxiety and Depression Scale, Seasonal Pattern Assessment Scale and Montgomery-Åsberg Depression Rating Scale. The study was registered at ClinicalTrials.gov (NCT00960232).ResultsParticipants with low 25(OH)D levels (n=230) at baseline were more depressed (P<0.05) than participants with high 25(OH)D levels (n=114). In the intervention study no significant effect of high-dose vitamin D was found on depressive symptom scores when compared with placebo.ConclusionsLow levels of serum 25(OH)D are associated with depressive symptoms, but no effect was found with vitamin D supplementation.

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Benefit of Clomipramine-quetiapine Combination in Obsessive-compulsive Disorder with Non Response to Serotonin Selective Reuptake Inhibitors. Case Report

European Psychiatry ◽

10.1016/s0924-9338(09)71267-2 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

G. Marian ◽

B. Ionescu ◽

D. Ghinea ◽

N. Alina

Keyword(s):

Obsessive Compulsive Disorder ◽

Rating Scale ◽

Case Series ◽

Antidepressant Medication ◽

Tricyclic Antidepressant ◽

Psychotic Symptoms ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Work Related ◽

Affective Symptoms

Background:Patients who suffer of obsessive-compulsive disorder (OCD) experience obsessive thoughts and/or urges to engage in compulsive behaviours. the condition causes severe discomfort and, in many cases, leads to serious impairment in social and work-related functioning.Although antipsychotic monotherapy has been associated with ineffectiveness and even increase of psychotic symptoms (especially in psychotic patients), antipsychotics as adjuvant to antidepressant medication have proven to be effective in several case series and pilot clinical trials.The objective of this case was to evaluate the effectiveness of clomipramine-quetiapine combination in OCD refractory to serotonin selective reuptake inhibitors treatment patient.Method:23 years unemployed male was diagnosed with OCD after 1 year from onset and received 3 trials with serotonin selective reuptake inhibitors at therapeutical doses, without any improvement and even more with worsening of affective associated symptoms. We managed this case by using a tricyclic antidepressant (clomipramine up to 100 mg/day) with an atypical antipsychotic (quetiapine up to 200 mg/day). We employed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Obsessive-Compulsive Checklist (OCC) and Hamilton Depression rating Scale (HDRS) at baseline, weekly for the first 2 months and monthly after (follow up 2 years).Results:Patient achieved a very fast and sustained improvement both in obsessive-compulsive and affective symptoms, which provided a very good social and work rehabilitation.Conclusion:Clomipramine-quetiapine combination may be a benefit for OCD refractory to serotonin selective reuptake inhibitors and a safe strategy.

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Quality of life in isolated dystonia: non-motor manifestations matter

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2020-325193 ◽

2021 ◽

pp. jnnp-2020-325193 ◽

Cited By ~ 2

Author(s):

Johanna Junker ◽

Brian D Berman ◽

James Hall ◽

Deena W Wahba ◽

Valerie Brandt ◽

...

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Social Anxiety ◽

Physical Functioning ◽

Rating Scale ◽

Depression Scale ◽

Standard Of Care ◽

Well Being ◽

Current Standard

ObjectiveTo evaluate the relationship between health-related quality of life (HR-QoL) and both physical and psychiatric factors in a large, international, multicentre cohort of patients with isolated dystonia, the Dystonia Coalition.MethodsNatural history data from 603 patients with isolated dystonia (median age 57 years (IQR: 48 to 64 years), 67.0% women) were prospectively acquired and analysed. HR-QoL (RAND 36-Item Health Survey), severity of depressive symptoms, generalised anxiety (Hospital Anxiety and Depression Scale) and social anxiety (Liebowitz Social Anxiety Scale) were assessed. Dystonia severity (Burke-Fahn-Marsden Dystonia Rating Scale) and dystonic tremor were examined. Statistical predictors of HR-QoL were calculated using saturated path analysis.ResultsReduced HR-QoL was strongly associated with the degree of depressive symptoms and generalised and social anxiety (8/8 RAND 36 subscales, p≤0.001). Increased dystonia severity was associated with worse physical functioning, physical and emotional role functioning and social functioning (all p≤0.001). The presence of tremor correlated with worse physical functioning and pain (all p≤0.006). Younger age was associated with reduced emotional well-being and vitality (all p≤0.006). There were no HR-QoL differences between sexes.ConclusionHR-QoL in isolated dystonia is strongly associated with psychiatric and physical features. While current standard of care focus on motor aspects of dystonia, comprehensive care should address both physical and mental aspects of health.

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Depression in Kraepelinian Schizophrenia

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v15i4.194 ◽

2009 ◽

Vol 15 (4) ◽

pp. 4

Author(s):

H E Naude ◽

Renata Ronelle Du Preez ◽

R Sykes ◽

H W Pretorius ◽

M J Van der Linde ◽

...

Keyword(s):

Depressive Symptoms ◽

Antipsychotic Medication ◽

First Generation ◽

Depression Scale ◽

Antidepressant Medication ◽

Severity Of Illness ◽

Chronic Schizophrenia ◽

Course Of Illness ◽

Clinical Global Impression Severity ◽

Severe Deterioration

Objective. Depressive symptoms are prevalent, under- recognised and clinically important in patients suffering from schizophrenia. Depressive symptoms in schizophrenia patients are associated with distinct morbidity and mortality. The objective of this study was to investigate the prevalence of depressive symptoms in a subgroup of chronic schizophrenia, Kraepelinian schizophrenia, and the association with severity of illness. Kraepelinian schizophrenia is characterised by a chronic, unremitting, severe course of illness and severe deterioration of functioning in social, work and self-care domains. Method. The Calgary Depression Scale for Schizophrenia (CDSS) and the Clinical Global Impression Severity (CGI-S) scale were administered to 113 patients who fulfilled the criteria of Kraepelinian schizophrenia. Results. Sixty-eight males and 45 females participated in the study. Of this group, 17.7% scored 5 or more on the CDSS. The CGI-S scores indicated that almost half of the patients were moderately ill (i.e. a score of 4 on the CGI-S scale). Of the patients, 94 were receiving first-generation antipsychotic medication and 19 second- generation antipsychotic medication. Thirteen patients were also receiving antidepressant medication. Conclusion. The findings of this study are consistent with current reports in the literature that depressive symptoms are not common in Kraepelinian schizophrenia, even though patients are moderately to severely ill in both symptom and functional domains.

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The validity of self-rated psychotic symptoms in depressed inpatients

European Psychiatry ◽

10.1016/j.eurpsy.2011.01.004 ◽

2012 ◽

Vol 27 (7) ◽

pp. 547-552 ◽

Cited By ~ 10

Author(s):

F. Seemüller ◽

M. Riedel ◽

M. Obermeier ◽

R. Schennach-Wolff ◽

I. Spellmann ◽

...

Keyword(s):

Depressive Symptoms ◽

Multicentre Trial ◽

Rating Scale ◽

Depression Score ◽

Psychotic Symptoms ◽

Symptom Checklist ◽

Psychotic Experiences ◽

Weak Correlation ◽

Madrs Total Score ◽

Epidemiological Surveys

AbstractBackgroundSelf-ratings of psychotic experiences might be biased by depressive symptoms.MethodData from a large naturalistic multicentre trial on depressed inpatients (n = 488) who were assessed on a biweekly basis until discharge were analyzed. Self-rated psychotic symptoms as assessed with the 90-Item Symptom Checklist (SCL-90) were correlated with the SCL-90 total score, the SCL-90 depression score, the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale 21 item (HAMD-21) total score, the Montgomery Åsberg Depression Rating Scale (MADRS) total score and the clinician-rated paranoid-hallucinatory score of the Association for Methodology and Documentation in Psychiatry (AMDP) scale.ResultsAt discharge the SCL-90 psychosis score correlated highest with the SCL-90 depression score (0.78, P<0.001) and with the BDI total score (0.64, P<0.001). Moderate correlations were found for the MADRS (0.34, P<0.001), HAMD (0.37, P<0.001) and AMDP depression score (0.33, P<0.001). Only a weak correlation was found between the SCL-90 psychosis score and the AMDP paranoid-hallucinatory syndrome score (0.15, P<0.001). Linear regression showed that change in self-rated psychotic symptoms over the treatment course was best explained by a change in the SCL-90 depression score (P<0.001). The change in clinician-rated AMDP paranoid-hallucinatory score had lesser influence (P = 0.02).ConclusionsIn depressed patients self-rated psychotic symptoms correlate poorly with clinician-rated psychotic symptoms. Caution is warranted when interpreting results from epidemiological surveys using self-rated psychotic symptom questionnaires as indicators of psychotic symptoms. Depressive symptoms which are highly prevalent in the general population might influence such self-ratings.

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A Comparative Trial of Depot Pipothiazine

Journal of International Medical Research ◽

10.1177/030006058601400204 ◽

1986 ◽

Vol 14 (2) ◽

pp. 72-77 ◽

Cited By ~ 6

Author(s):

J Steinert ◽

A Neder ◽

E Erba ◽

C R Pugh ◽

C Robinson ◽

...

Keyword(s):

Side Effects ◽

Rating Scales ◽

Rating Scale ◽

Statistical Significance ◽

Depression Scale ◽

Psychotic Symptoms ◽

Biochemical Tests ◽

Psychiatric Rating ◽

Psychiatric Rating Scale ◽

Flupenthixol Decanoate

Thirty-nine chronic schizophrenic patients were selected for a 12-month double-blind evaluation of the effectiveness of pipothiazine palmitate (PPT) and flupenthixol decanoate (FPX) in the maintenance management of their illness. Allocation was at random and, in order to allow constant injection intervals, the patients typically received every 2 weeks either 40 mg of flupenthixol decanoate or alternating injections of 100 mg of pipothiazine palmitate and placebo. At monthly intervals the patients were assessed using both a battery of rating scales (which included the Brief Psychiatric Rating Scale (BPRS), the Extrapyramidal Symptoms Rating Scale (EPS)) and a general side-effects evaluation. At 3-monthly intervals they were also rated on the Comprehensive Psychiatric Rating Scale (CPRS) and the Zung Depression Scale. Haematological and biochemical tests were performed every 3 months. Both drugs provided good control of psychotic symptoms and side-effects were not troublesome. No substantial difference was detected on the CPRS and the Zung scales. There was a trend in favour of PPT on the BPRS survey, detectable at 6 months and reaching statistical significance by 12 months. We conclude that the PPT regime is at least as effective as the FPX treatment and probably more so. It is possible that even longer periods of control could be obtained with PPT.

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