Zisook S, McAdams L A, Kuck J, Harris M J, Bailey A, Patterson T L, Judd L L, Jeste D V
Department of Psychiatry, University of California, San Diego, and the San Diego VA Healthcare System, 92161, USA.
Am J Psychiatry. 1999 Nov;156(11):1736-43. doi: 10.1176/ajp.156.11.1736.
The authors assessed the presence and severity of depressive symptoms, as well as their associations with other clinical measures, in a group of mid- to late-life patients with schizophrenia who were not in a major depressive episode or diagnosed with schizoaffective disorder.
Sixty outpatients with schizophrenia between the ages of 45 and 79 years and 60 normal comparison subjects without major neuropsychiatric disorders, proportionally matched for age and gender, were studied. Depressive symptoms were rated primarily with the Hamilton Depression Rating Scale. Standardized instruments were also used to measure global psychopathology, positive and negative symptoms, abnormalities of movement, and global cognitive status.
Depressive symptoms were more frequent and more severe in schizophrenic patients than in normal comparison subjects; 20% of the women with schizophrenia had a Hamilton depression scale score of 17 or more. Severity of depressive symptoms correlated with that of positive symptoms but not with age, gender, negative symptoms, extrapyramidal symptoms, or neuroleptic dose.
Depressive symptoms are common in older patients with schizophrenia. They may be an independent, core component of the disorder or, alternatively, may be a by-product of severe psychotic symptoms.
作者评估了一组未处于重度抑郁发作或未被诊断为分裂情感性障碍的中老年精神分裂症患者抑郁症状的存在情况和严重程度,以及这些症状与其他临床指标的关联。
研究了60名年龄在45至79岁之间的精神分裂症门诊患者和60名无重大神经精神疾病的正常对照受试者,后者在年龄和性别上按比例匹配。主要使用汉密尔顿抑郁量表对抑郁症状进行评分。还使用标准化工具来测量整体精神病理学、阳性和阴性症状、运动异常以及整体认知状态。
精神分裂症患者的抑郁症状比正常对照受试者更频繁、更严重;20%的精神分裂症女性患者汉密尔顿抑郁量表得分达到或超过17分。抑郁症状的严重程度与阳性症状的严重程度相关,但与年龄、性别、阴性症状、锥体外系症状或抗精神病药物剂量无关。
抑郁症状在老年精神分裂症患者中很常见。它们可能是该疾病的一个独立核心成分,或者可能是严重精神病性症状的一个副产品。