University Clinic of Psychiatry, Belgradska bb, 1000 Skopje, Macedonia.
EPMA J. 2011 Dec;2(4):391-402. doi: 10.1007/s13167-011-0103-0. Epub 2011 Aug 12.
Depressive symptoms are common in schizophrenia and they can occur during any phase of the disorder. Early diagnosis, adequate differential diagnosis and promptly initiated interventions have been shown to reduce further deterioration of illness and to improve patients' quality of life. Common psychiatric rating scales for early detection of depressive symptoms in schizophrenia are Calgary Depression Scale for Schizophrenia and Hamilton Depression Rating Scale, but the most appropriate assessment instrument today regarding this topic is Calgary Depression Scale for Schizophrenia. Treatment of depression in schizophrenia consists of a combination of pharmacologic and psychosocial approach. Atypical antipsychotics have advantages over typical in reducing depressive symptoms in the context of schizophrenia. Most of the studies referred that clozapine, olanzapine, quetiapine and risperidone have an antidepressant spectrum of activity in patients with schizophrenia. Antidepressant augmentation of antipsychotic treatment in schizophrenic patients with depressive symptoms improves depressive symptomatology, particularly SSRI and SNRI augmentation.
抑郁症状在精神分裂症中很常见,可发生于疾病的任何阶段。早期诊断、充分的鉴别诊断和及时干预已被证明可以减少疾病的进一步恶化,提高患者的生活质量。用于早期检测精神分裂症中抑郁症状的常见精神科评定量表有 Calgary 精神分裂症抑郁量表和汉密尔顿抑郁评定量表,但目前关于这一主题的最合适的评估工具是 Calgary 精神分裂症抑郁量表。精神分裂症中抑郁的治疗包括药物和心理社会治疗的结合。非典型抗精神病药物在改善精神分裂症患者的抑郁症状方面优于典型抗精神病药物。大多数研究表明,氯氮平、奥氮平、喹硫平和利培酮在精神分裂症患者中有抗抑郁作用。在有抑郁症状的精神分裂症患者中,抗精神病药物治疗联合使用抗抑郁药物可改善抑郁症状,特别是 SSRI 和 SNRIs 增效治疗。