Association of Depressive Symptoms With Worse Functioning in Schizophrenia: A Study in Older Outpatients
J Clin Psychiatry 2001;62(10):797-803
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Subsyndromal depressive symptoms are
highly prevalent and associated with substantial impairments of
daily function in the general population. Depressive symptoms are
common in schizophrenia. However, few studies have examined the
relationship of functioning and well-being to the presence of
depressive symptoms in schizophrenia.
Method: 202 middle-aged or elderly outpatients
with schizophrenia (DSM-III-R or DSM-IV criteria) were
categorized by severity of depressive symptoms on the Hamilton
Rating Scale for Depression (HAM-D) using previously validated
cutoff points, i.e., HAM-D total score <= 6 (low), from 7 to
16 (medium), and >= 17 (high). We also assessed severity of
positive and negative symptoms, movement disorders,
neurocognitive performance, daily functioning, and health-related
quality of well-being with standardized measures.
Results: A total of 11.4% of patients had HAM-D
scores >=17, and 56.4% had HAM-D scores from 7 to 16. Even
after adjusting for severity of other psychopathology, patients
with more severe depressive symptoms had significantly worse
everyday functioning (p < .02), except for physical
functioning, and health-related quality of well-being (r = -.365,
p < .001) than did those with lower HAM-D scores. These
differences were unrelated to those in demographics,
extrapyramidal symptoms, tardive dyskinesia, neurocognitive
performance, or number of physical illnesses.
Conclusion: The results suggest the importance
of evaluating schizophrenia patients for the presence of
depressive symptoms. Effectiveness of adjunct treatment of
depressive symptoms with antidepressants and psychosocial
management in improving functioning of schizophrenia patients
deserves further study.