Department of Psychiatry, Stellenbosch University, Cape Town 7500, South Africa.
Department of Psychiatry, Stellenbosch University, Cape Town 7500, South Africa.
Psychiatry Res. 2021 Apr;298:113767. doi: 10.1016/j.psychres.2021.113767. Epub 2021 Jan 29.
Depressive symptoms are common in schizophrenia and have been associated with both favourable and unfavourable outcomes. We studied the longitudinal course of depressive symptoms and explored their temporal relationships with other manifestations of the illness and its treatment. This longitudinal cohort study included 126 antipsychotic naïve or only briefly treated patients with first-episode schizophrenia spectrum disorders treated with a long-acting antipsychotic over 24 months. Depressive symptoms were assessed at three monthly intervals using the Calgary Depression Scale for Schizophrenia and changes over time were assessed using linear mixed-effect models for continuous repeated measures. Depressive symptoms were most prominent at baseline with highly significant reductions during the first three months of treatment and maintenance of improvement thereafter. Most improvement occurred with antipsychotic treatment alone, with few patients requiring additional antidepressants. We also found that depressive symptoms were associated with positive symptoms, better insight and poorer quality of life, but not with negative symptoms, extrapyramidal symptoms, substance use or cumulative antipsychotic dose.There were few differences between patients who met criteria for depression during the acute phase of treatment and those in the post-acute phase.
抑郁症状在精神分裂症中很常见，与有利和不利的结果都有关。我们研究了抑郁症状的纵向病程，并探讨了其与疾病其他表现及其治疗的时间关系。这项纵向队列研究包括 126 名首次发作的精神分裂症谱系障碍的抗精神病药物初治或仅短期治疗的患者，他们在 24 个月内接受长效抗精神病药物治疗。使用 Calgary 精神分裂症抑郁量表每三个月评估一次抑郁症状，并使用线性混合效应模型评估连续重复测量的时间变化。抑郁症状在基线时最为明显，治疗前三个月有显著下降，此后保持改善。大多数改善发生在单独使用抗精神病药物时，很少有患者需要额外使用抗抑郁药。我们还发现，抑郁症状与阳性症状、更好的洞察力和较差的生活质量有关，但与阴性症状、锥体外系症状、物质使用或累积抗精神病药物剂量无关。在治疗急性期符合抑郁症标准的患者和急性后阶段的患者之间几乎没有差异。
