Depressive symptoms and their association with acute treatment outcome in first-episode schizophrenia patients: Comparing treatment with risperidone and haloperidol

Abstract Background The relationship between schizophrenia and depression is complex. Longitudinal studies on the course of depression in first episode schizophrenia populations are scarce and there are conflicting results on the predictive value of some baseline measures. Methods We conducted an open label longitudinal cohort study which included 126 patients with first-episode schizophrenia spectrum disorders treated with long-acting antipsychotic medication over 24 months. Depression was assessed at three monthly intervals using the Calgary Depression Scale for Schizophrenia. Changes in depression over time were assessed using the linear mixed-effect models for continuous repeated measures. The relationship between depression and other clinical parameters was assessed with regression models. Results Depressive symptoms were most prominent at baseline and showed highly significant reductions in the first three months (p<0.0001). Majority of the patients with depression improved with antipsychotic medication alone and we found associations between depressive symptoms with insight and poorer quality of life, however only illness awareness (p=0.0035) was the only significant predictor on depression in our regression analysis. There were a few differences between patients who experienced depression during the acute phase of treatment and those in the post-acute phase. Discussion Our findings suggest that depression in schizophrenia is common and generally responds well to treatment. The relationship between depression and insight has implications for further treatment considerations

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Naturalistic follow-up of co-morbid substance use in schizophrenia: the West London first-episode study

Psychological Medicine ◽

10.1017/s0033291707000797 ◽

2007 ◽

Vol 38 (1) ◽

pp. 79-88 ◽

Cited By ~ 54

Author(s):

I. Harrison ◽

E. M. Joyce ◽

S. H. Mutsatsa ◽

S. B. Hutton ◽

V. Huddy ◽

...

Keyword(s):

Substance Use ◽

Depressive Symptoms ◽

Negative Symptoms ◽

Spatial Working Memory ◽

Problem Drinking ◽

Specific Treatment ◽

First Episode ◽

First Episode Schizophrenia ◽

The Impact

BackgroundThe impact of co-morbid substance use in first-episode schizophrenia has not been fully explored.MethodThis naturalistic follow-up of a cohort of 152 people with first-episode schizophrenia examined substance use and clinical outcome in terms of symptoms and social and neuropsychological function.ResultsData were collected on 85 (56%) of the patient cohort after a median period of 14 months. Over the follow-up period, the proportion of smokers rose from 60% at baseline to 64%. While 30% reported lifetime problem drinking of alcohol at baseline, only 15% had problem drinking at follow-up. Furthermore, while at baseline 63% reported lifetime cannabis use and 32% were currently using the drug, by the follow-up assessment the latter figure had fallen to 18.5%. At follow-up, persistent substance users had significantly more severe positive and depressive symptoms and greater overall severity of illness. A report of no lifetime substance use at baseline was associated with greater improvement in spatial working memory (SWM) at follow-up.ConclusionsPast substance use may impede recovery of SWM performance in people with schizophrenia in the year or so following first presentation to psychiatric services. The prevalence of substance use other than tobacco tends to diminish over this period, in the absence of specific interventions. Persistent substance use in first-episode schizophrenia is associated with more severe positive and depressive symptoms but not negative symptoms, and should be a target for specific treatment intervention.

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