AP-HP, Western Paris University Hospitals, Department of Psychiatry, Issy-les-Moulineaux 92130, France; INSERM UMR 894, Psychiatry and Neurosciences Center, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France.
AP-HP, Western Paris University Hospitals, Department of Psychiatry, Issy-les-Moulineaux 92130, France.
J Affect Disord. 2019 May 15;251:60-70. doi: 10.1016/j.jad.2019.03.007. Epub 2019 Mar 6.
Few studies have examined the prevalence and correlates of subsyndromal and syndromal depressive symptoms (SSSD) among older adults with schizophrenia spectrum disorder. In this report, we examined the prevalence of SSSD and their associations with sociodemographic characteristics, clinical characteristics of schizophrenia, comorbidity, psychotropic medications, quality of life, functioning and mental health care utilization in a large, multicenter sample of older adults with schizophrenia spectrum disorder.
Data from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) were used to examine the prevalence of SSSD, defined using the Center of Epidemiologic Studies Depression (CESD) scale. Clinical characteristics associated with SSSD were explored.
Among 343 older adults with schizophrenia spectrum disorder, 78.1% had either subsyndromal (30.6%) or syndromal (47.5%) depressive symptoms. SSSD were independently associated with positive and negative symptoms, lower quality of life, non-late-onset psychosis, benzodiazepine use and urbanicity. There were no significant associations of SSSD with other sociodemographic characteristics and psychotropic medications, or with general medical conditions. We found no significant differences in the proportion of participants who were treated with antidepressants between those with syndromal depressive symptoms and those without depression (22.1% vs. 20.0%, p = 0.89). SSSD were not associated with higher mental health care utilization.
Data were cross-sectional and depression was not evaluated with a semi-structured interview.
SSSD may be highly prevalent and under-assessed and/or undertreated among older adults with schizophrenia spectrum disorder. Our findings should alert clinicians about the need to assess systematically and regularly depression in this vulnerable population.
鲜有研究调查过精神分裂症谱系障碍老年患者亚综合征和综合征性抑郁症状（SSSD）的流行率及其相关因素。本报告中，我们调查了大样本多中心精神分裂症谱系障碍老年患者中 SSSD 的流行率，及其与人口统计学特征、精神分裂症的临床特征、合并症、精神类药物、生活质量、功能和精神卫生保健利用之间的关系。
我们使用老年人精神分裂症队列（CSA）的数据来检测 SSSD 的流行率，使用流行病学研究中心抑郁量表（CESD）进行定义。探索了与 SSSD 相关的临床特征。
在 343 名精神分裂症谱系障碍老年患者中，78.1%存在亚综合征（30.6%）或综合征性（47.5%）抑郁症状。SSSD 与阳性和阴性症状、较低的生活质量、非迟发性精神病、苯二氮䓬类药物使用和城市性独立相关。SSSD 与其他人口统计学特征和精神类药物或一般医疗状况无显著关联。我们发现，有综合征性抑郁症状和无抑郁症状的患者中接受抗抑郁治疗的比例没有显著差异（22.1% vs. 20.0%，p=0.89）。SSSD 与更高的精神卫生保健利用无关。
数据为横断面研究，且抑郁未通过半结构式访谈进行评估。
精神分裂症谱系障碍老年患者中 SSSD 可能高度流行，但评估不足和/或治疗不足。我们的研究结果应提醒临床医生需要系统和定期地评估这一脆弱人群的抑郁情况。
