The burden of depressive symptoms in people with schizophrenia.

People with schizophrenia and concurrent depressive symptoms have poorer long-term functional outcomes compared with the nondepressed. 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 nonpsychotic dimensions of schizophrenia is a critical part of recovery. In a 3-year study, the depressed cohort was significantly more likely than the nondepressed to use relapse-related mental health services (emergency psychiatric services, sessions with psychiatrists); to be a safety concern (violent, arrested, victimized, or 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.