Sönmez Nasrettin, Romm Kristin Lie, Andreasssen Ole A, Melle Ingrid, Røssberg Jan Ivar
BMC Psychiatry. 2013 Apr 5;13:106. doi: 10.1186/1471-244X-13-106.
Depressive symptoms are common in patients with first episode psychosis (FEP) and have serious consequences for them. The main aims of this study were to examine the course of depression in FEP patients and explore whether any patient characteristics at baseline predicts depressive symptoms after one year.
A total of 198 FEP patients with schizophrenia spectrum disorders were assessed for depressive symptoms with Calgary Depression Scale for Schizophrenia (CDSS) at baseline and 127 were followed for one year. A CDSS score [greater than or equal to] 6 was used as a cut-off score for depression.
Approximately 50% of the patients were depressed (CDSS[greater than or equal to]6) at baseline. At follow-up approximately 35% had depression. The course of depressive symptoms varied, 26% was depressed at both baseline and follow-up, 9% became depressed during the follow-up, 22% remitted from depression during the 12 months and 43% was neither depressed at baseline nor at follow-up. Poor childhood social functioning, long duration of untreated psychosis (DUP) and depressive symptoms at baseline predicted depression at 12 months follow-up.
Depressive symptoms are frequent in the first year after onset of psychosis. Patients with poor social functioning in childhood, long DUP and depressive symptoms at baseline are more prone to have depressive symptoms after one year. These patients should be identified and proper treatment provided.
抑郁症状在首发精神病(FEP)患者中很常见,且会给他们带来严重后果。本研究的主要目的是研究FEP患者的抑郁病程,并探讨基线时的任何患者特征是否能预测一年后的抑郁症状。
共有198例患有精神分裂症谱系障碍的FEP患者在基线时用卡尔加里精神分裂症抑郁量表(CDSS)评估抑郁症状,其中127例随访一年。CDSS评分大于或等于6被用作抑郁的临界值。
约50%的患者在基线时抑郁(CDSS≥6)。随访时约35%有抑郁症状。抑郁症状的病程各不相同,26%在基线和随访时均抑郁,9%在随访期间出现抑郁,22%在12个月内抑郁症状缓解,43%在基线和随访时均无抑郁症状。童年社会功能差、未治疗精神病的持续时间长(DUP)以及基线时的抑郁症状可预测12个月随访时的抑郁。
精神病发作后的第一年抑郁症状很常见。童年社会功能差、DUP长以及基线时有抑郁症状的患者在一年后更易出现抑郁症状。应识别出这些患者并给予适当治疗。