Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
Qingdao Mental Health Center, Qingdao University, Qingdao, China.
J Affect Disord. 2021 Nov 1;294:33-38. doi: 10.1016/j.jad.2021.06.075. Epub 2021 Jul 5.
Depression is very common in patients with schizophrenia, but few studies have investigated the diagnosed major depressive episode (MDE) in first episode and drug naive (FEDN) schizophrenia. To our best knowledge, this is the first large sample study to examine the prevalence, clinical correlates and associated factors of diagnosed MDE in FEDN schizophrenia, as well as the relationship between depressive symptoms and psychopathological symptoms in these schizophrenia patients.
A total of 996 FEDN schizophrenia patients were recruited. The 17-item Hamilton Depression Rating Scale (HAMD17) and Positive and Negative Syndrome Scale (PANSS) were used to assess the severity of depression and psychopathology, respectively.
Our results demonstrated that MDE coexisted in nearly half (49.30%) of FEDN schizophrenia patients. Male gender, smoking, PANSS general psychopathology and early age of onset were associated with MDE in patients with FEDN schizophrenia (all p<0.05). In schizophrenia patients with MDE, oridinal logistic regression showed that men (OR=6.65, 95%CI: 4.12-10.45, p<0.001) and smoking (OR=1.94, 95%CI: 1.25-3.01, p=0.003) were positively associated with severity category of depression (all p<0.05), while multivariate regression showed that HAMD17 total score was significantly associated with the PANSS general psychopathology (B=0.06, t=2.72, p=0.007) and total scores (B=0.04, t=2.57, p=0.01).
Our study shows that the prevalence of comorbid MDE is high in FEDN schizophrenia patients. Some demographic and clinical variables are associated with the severity of depression in these schizophrenia patients.
抑郁症在精神分裂症患者中非常常见，但很少有研究调查首发未用药精神分裂症（FEDN）患者中确诊的重度抑郁发作（MDE）。据我们所知，这是第一项大规模样本研究，旨在检查 FEDN 精神分裂症患者中确诊 MDE 的患病率、临床相关性和相关因素，以及这些精神分裂症患者中抑郁症状与精神病理症状之间的关系。
共招募了 996 例 FEDN 精神分裂症患者。使用 17 项汉密尔顿抑郁评定量表（HAMD17）和阳性和阴性综合征量表（PANSS）分别评估抑郁严重程度和精神病理症状。
我们的结果表明，MDE 在近一半（49.30%）的 FEDN 精神分裂症患者中同时存在。男性、吸烟、PANSS 一般精神病理和发病年龄较早与 FEDN 精神分裂症患者的 MDE 有关（均 p<0.05）。在有 MDE 的精神分裂症患者中，原始逻辑回归显示男性（OR=6.65，95%CI：4.12-10.45，p<0.001）和吸烟（OR=1.94，95%CI：1.25-3.01，p=0.003）与抑郁严重程度类别呈正相关（均 p<0.05），而多元回归显示 HAMD17 总分与 PANSS 一般精神病理（B=0.06，t=2.72，p=0.007）和总分（B=0.04，t=2.57，p=0.01）显著相关。
我们的研究表明，FEDN 精神分裂症患者并发 MDE 的患病率较高。一些人口统计学和临床变量与这些精神分裂症患者的抑郁严重程度相关。
