Zoja Babinkostova, Branislav Stefanovski and Silvana Naunova-Timovska
Depression Intensity in Patients with Schizophrenia
Background: Depressive symptoms are common in schizophrenia and they can occur during any phase of the disorder. Previous studies indicate that depression in schizophrenic patients is generally with mild or moderate intensity.
Aim: We undertook this study with the aim of evaluation of the presence and intensity of the depressive symptoms in patients with schizophrenia.
Material and Methods: The examined group consisted of 50 patients with schizophrenic disorder, both inpatients and outpatients treated at the University Clinic of Psychiatry, who had prominent depressive symptoms (total score >7 on 17-item Hamilton Depression Rating Scale). The control group consisted of 50 patients with depressive disorder. Differential diagnosis was established on the basis of ICD-10 diagnostic criteria. Patients were evaluated with PANSS, 17-item Hamilton Depression Rating Scale (HAMD) and a questionnaire for demographic and clinical data.
Results: The percentage of patients with depressive symptoms among the patients with schizophrenic disorder was 54%. Schizophrenic patients more frequently presented mild and moderate depression in comparison to the control group in which moderate and severe depression were more frequent.
Conclusion: Patients with schizophrenia more frequently present mild and moderate depression.
Background: Previous studies suggested that alterations in serum cortisol and DHEA-S levels may play a role in the pathophysiology of schizophrenia. Imbalance in serum cortisol and DHEA-S levels may be related to responsivity to antipsychotic treatment.
Aim: To compare serum cortisol and DHEA-S levels between patients with schizophrenia and healthy controls and to evaluate their association with psychopathology in schizophrenic patients with different response to antipsychotic treatment.
Material and Methods: This clinical prospective study included 60 patients with schizophrenia and 40 healthy age and sex matched controls. All patients experienced an acute exacerbation of the illness (PANSS: P1 and P3 ≥ 4). Clinical evaluation of patients was performed using the Positive and Negative Symptom Scale. A questionnaire for socio-demographic and clinical data collection was used. For the purposes of the study, the examined group was divided in two subgroups: responders and nonresponders. Serum cortisol and DHEA-S levels were measuredat baseline in all participants and after 3 and 6 weeks of the antipsychotic treatment in patients with schizophrenia.
Results: Patients with schizophrenia had significantly higher serum cortisol and DHEA-S levels comparedwith control group. Responders had significantly higher serum cortisol and DHEA-S levels compared with nonresponders. Responders group had significant correlation between serum cortisol and PANSS positive scale score as well as between hostility and serum DHEA-S.
Conclusion: Elevated serum cortisol and DHEA-S levels may play a role in the pathophysiology of schizophrenia. Serum cortisol and DHEA-S are associated with psychopathology in schizophrenic patients with different response to antipsychotic therapy.