The burden of depressive symptoms in the long-term treatment of patients with schizophrenia

SCHIZOPHRENIA RESEARCH

卷:90

Article

Conley, Robert R. ; Ascher-Svanum, Haya ; Zhu, Baojin ; Faries, Douglas E. ; Kinon, Bruce J.

关键词: schizophrenia;    depressive symptoms;    depression;    outcomes;   

DOI  :  10.1016/j.schres.2006.09.027

来源: Elsevier

【 摘 要 】

Objective: To prospectively measure the link between depressive symptoms and functional outcomes in the long-term treatment of people with schizophrenia. Methods: Data were drawn from a large, multi-site, 3-year, prospective, naturalistic, observational study, in which subjects with schizophrenia were assessed at enrollment and at 12-month intervals thereafter. Individuals who were Depressed (defined as a total score >= 16 on the Montgomery-Asberg Depression Rating Scale) at enrollment were compared to those Non-depressed on functional outcomes, using self-report measures, clinicians' ratings, and information from medical records. Statistical analyses included Generalized Estimation Equation and mixed regression analyses adjusted for individual characteristics. Longitudinal group comparisons across the 3-year study were augmented with a cross-sectional group comparison at enrollment. Results: At enrollment, 39.4% (877/2228) of the participants were deemed Depressed. Across the 3-year study, the depressed cohort was significantly more likely than the Non-depressed to use relapse-related mental health services (emergency psychiatric services, sessions with psychiatrists); to be a safety concern (violent, arrested, victimized, suicidal); to have greater substance-related problems; and to report poorer life satisfaction, quality of life, mental functioning, family relationships, and medication adherence. Furthermore, changes in depressed status were associated with changes in functional outcomes. Conclusions: People with schizophrenia and concurrent depressive symptoms have poorer long-term functional outcomes compared to the Non-depressed. Their poorer quality of life, greater use of mental health services, and higher risk of involvement with law enforcement agencies underscore a need for special treatment interventions. Treatment of the non-psychotic dimensions of schizophrenia is a critical part of recovery. (c) 2006 Elsevier B.V. All rights reserved.

【 授权许可】

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