Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Int J Soc Psychiatry. 2017 May;63(3):181-194. doi: 10.1177/0020764017691314. Epub 2017 Feb 5.
To evaluate the prevalence of depression using different measures in patients with schizophrenia and to study the relationship of depression in schizophrenia with cognitive insight and clinical insight, disability and socio-occupational functioning.
A total of 136 patients with schizophrenia were evaluated for depression, cognitive insight and socio-occupational functioning.
Of the 136 patients included in the study, one-fourth ( N = 34; 25%) were found to have depression as per the Mini International Neuropsychiatric Interview (MINI). The prevalence of depression as assessed by Calgary Depression Scale for Schizophrenia (CDSS), Hamilton depression rating scale (HDRS) and Depressive Subscale of Positive and Negative Syndrome Scale (PANSS-D) was 23.5%, 19.9% and 91.9%, respectively. Among the different scales, CDSS has highest concordance with clinician's diagnosis. Sensitivity, specificity, positive predictive value and negative predictive value for CDSS was also higher than that noted for HDRS and PANSS-D. When those with and without depression as per clinician's diagnosis were compared, those with depression were found to have significantly higher scores on Positive and Negative Syndrome Scale (PANSS) positive and general psychopathology subscales, PANSS total score, participation restriction as assessed by P-scale and had lower level of functioning as assessed by Global Assessment of Functioning (GAF). No significant difference was noted on negative symptom subscale of PANSS, clinical insight as assessed on G-12 item of PANSS, disability as assessed by Indian Disability Evaluation and Assessment Scale (IDEAS) and socio-occupational functioning as assessed by Social and Occupational Functioning Assessment Scale (SOFS). In terms of cognitive insight, those with depression had significantly higher score for both the subscales, that is, self-reflective and self-certainty subscales as well as the mean composite index score.
Our results suggest that one-fourth of patients with schizophrenia have depression, compared to HDRS and PANSS-D, CDSS has highest concordance with clinician's diagnosis of depression and presence of depression is related to cognitive insight.
使用不同的评估工具评估精神分裂症患者的抑郁患病率，并研究精神分裂症患者的抑郁与认知洞察力、临床洞察力、残疾和社会职业功能之间的关系。
对 136 例精神分裂症患者进行抑郁、认知洞察力和社会职业功能评估。
在纳入研究的 136 例患者中，有四分之一（N=34；25%）根据 Mini 国际神经精神访谈（MINI）被诊断为患有抑郁。根据 Calgary 精神分裂症抑郁量表（CDSS）、汉密尔顿抑郁评定量表（HDRS）和阳性和阴性症状量表抑郁分量表（PANSS-D）评估的抑郁患病率分别为 23.5%、19.9%和 91.9%。在不同的量表中，CDSS 与临床医生的诊断具有最高的一致性。CDSS 的灵敏度、特异性、阳性预测值和阴性预测值也高于 HDRS 和 PANSS-D。当根据临床医生的诊断将有和无抑郁的患者进行比较时，发现有抑郁的患者在阳性和一般精神病量表、PANSS 总分、P 量表评估的参与受限以及全球功能评估（GAF）评估的功能水平方面得分显著更高。在 PANSS 的阴性症状量表、PANSS 的 G-12 项评估的临床洞察力、印度残疾评估和评估量表（IDEAS）评估的残疾以及社会和职业功能评估量表（SOFS）评估的社会职业功能方面没有显著差异。在认知洞察力方面，抑郁患者的两个分量表，即自我反思和自我确定分量表以及平均综合指数得分都显著更高。
我们的研究结果表明，与 HDRS 和 PANSS-D 相比，四分之一的精神分裂症患者患有抑郁，CDSS 与临床医生对抑郁的诊断具有最高的一致性，并且抑郁的存在与认知洞察力有关。
