Nasrettin Sönmez1,2, Jan Ivar Røssberg1,2, Julie Evensen1,2, Helene Eidsmo Barder1,3, Ulrik Haahr4, Wenche Ten Velden Hegelstad5, Inge Joa5,6, Jan Olav Johannessen5,6, Hans Langeveld5, Tor Ketil Larsen5,7, Ingrid Melle1,2, Stein Opjordsmoen1,2, Bjørn Rishovd Rund3,8, Erik Simonsen9, Per Vaglum10, Thomas McGlashan11, Svein Friis1,2. 1. Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. 2. Institute of Clinical Medicine, University of Oslo, Oslo, Norway. 3. Departments of Psychology, University of Oslo, Oslo, Norway. 4. Early Psychosis Intervention Center, Psychiatry Roskilde, Region Zealand, Roskilde, Denmark. 5. Regional Centre for Clinical Research in Psychosis, Psychiatric Division, Stavanger University Hospital, Stavanger, Norway. 6. Faculty of Social Sciences, University of Stavanger, Stavanger, Norway. 7. Institute of Psychiatry, University of Bergen, Bergen, Norway. 8. Vestre Viken Hospital Trust, Drammen, Norway. 9. Psychiatric Research Unit, Zealand Region, Psychiatry Roskilde, Roskilde University and University of Copenhagen, Roskilde, Denmark. 10. Department of Behavioral Sciences in Medicine, University of Oslo, Oslo, Norway. 11. Department of Psychiatry, Yale University School of Medicine, Yale Psychiatric Research at Congress Place, New Haven, Connecticut, USA.
Abstract
AIMS: The present study examined if any patient characteristics at baseline predicted depressive symptoms at 10 years and whether patients prone to depressive symptoms in the first year of treatment had a different prognosis in the following years. METHOD: A total of 299 first-episode psychosis (FEP) patients with schizophrenia spectrum disorders were assessed for depressive symptoms with PANSS depression item (g6) at baseline, and 1, 2, 5 and 10 years of follow up. At 10 years, depressive symptoms were also assessed with Calgary Depression Scale for Schizophrenia (CDSS). A PANSS g6 ≥ 4 and CDSS score ≥ 6 were used as a cut-off score for depression. RESULTS: A total of 122 (41%) patients were scored as depressed at baseline, 75 (28%) at 1 year, 50 (20%) at 2 years, 33 (16%) at 5 years, and 35 (19%) at 10 years of follow up. Poor childhood social functioning and alcohol use at baseline predicted depression at 10 years of follow up. Thirty-eight patients were depressed at both baseline and 1 year follow up. This group had poorer symptomatic and functional outcome in the follow-up period compared to a group of patients with no depression in the first year of treatment. CONCLUSION: Depressive symptoms are frequent among FEP patients at baseline but decrease after treatment because their general symptoms have been initiated. Patients with poor social functioning in childhood and alcohol use at baseline are more prone to have depressive symptoms at 10 years of follow up. Patients struggling with depressive symptoms in the first year of treatment should be identified as having poorer long-term prognosis.
AIMS: The present study examined if any patient characteristics at baseline predicted depressive symptoms at 10 years and whether patients prone to depressive symptoms in the first year of treatment had a different prognosis in the following years. METHOD: A total of 299 first-episode psychosis (FEP) patients with schizophrenia spectrum disorders were assessed for depressive symptoms with PANSS depression item (g6) at baseline, and 1, 2, 5 and 10 years of follow up. At 10 years, depressive symptoms were also assessed with Calgary Depression Scale for Schizophrenia (CDSS). A PANSS g6 ≥ 4 and CDSS score ≥ 6 were used as a cut-off score for depression. RESULTS: A total of 122 (41%) patients were scored as depressed at baseline, 75 (28%) at 1 year, 50 (20%) at 2 years, 33 (16%) at 5 years, and 35 (19%) at 10 years of follow up. Poor childhood social functioning and alcohol use at baseline predicted depression at 10 years of follow up. Thirty-eight patients were depressed at both baseline and 1 year follow up. This group had poorer symptomatic and functional outcome in the follow-up period compared to a group of patients with no depression in the first year of treatment. CONCLUSION:Depressive symptoms are frequent among FEP patients at baseline but decrease after treatment because their general symptoms have been initiated. Patients with poor social functioning in childhood and alcohol use at baseline are more prone to have depressive symptoms at 10 years of follow up. Patients struggling with depressive symptoms in the first year of treatment should be identified as having poorer long-term prognosis.
Authors: Jacob Cookey; Jacob McGavin; Candice E Crocker; Kara Matheson; Sherry H Stewart; Philip G Tibbo Journal: Can J Psychiatry Date: 2020-02-04 Impact factor: 4.356
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