Yanmei Shen1,2, Ying Wei3, Xu-Na Yang4, Guangya Zhang4, Xiangdong Du4, Qiufang Jia4, Xiaomin Zhu4, Yuejiao Ma1,2, XiaoE Lang5, Xuerong Luo1,2, Xiang Yang Zhang6,7. 1. Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China. 2. Department of Psychiatry, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan, China. 3. Department of Psychiatry, Changshu Third Hospital of People, Changshu, Jiangshu, China. 4. Department of Psychiatry, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China. 5. Department of Psychiatry, The First Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, China. 6. Psychological Counseling Center, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China. 7. Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
Abstract
BACKGROUND: Many patients with major depressive disorder (MDD) have been found to have psychotic symptoms. However, few studies have reported the prevalence of comorbid psychotic symptoms in first-episode drug naïve (FEDN) MDD patients. This study was to investigate the prevalence of psychotic symptoms and related risk factors in a large sample size of FEDN MDD patients in a Chinese population. METHODS: A total of 573 patients with diagnosis of MDD at their first episode were recruited with their demographic and clinical data. Positive scale of the Positive and Negative Syndrome Scale was utilized for psychotic symptoms, Hamilton Anxiety Rating Scale (HAMA) for anxiety symptoms, and Hamilton Depression Rating Scale (HAMD) for depressive symptoms. RESULTS: The prevalence of psychotic symptoms in these MDD patients was 9.8%. MDD patients with psychotic symptoms had significantly higher HAMD and HAMA total scores than those without psychotic symptoms (both p < .001). A strong association was found between psychotic MDD and anxiety or suicide, with odds ratio of 33.097 for severe anxiety, and 5.012 for suicide. CONCLUSIONS: Our results suggest that psychotic symptoms are common in MDD patients at their first episode. The strong association between psychotic MDD and anxiety or suicide attempts demonstrates the importance of reducing anxiety symptoms in the treatment of psychotic MDD patients as well as the necessity to regularly assess suicide risk in MDD patients with psychotic symptoms to better prevent suicidal behavior.
BACKGROUND: Many patients with major depressive disorder (MDD) have been found to have psychotic symptoms. However, few studies have reported the prevalence of comorbid psychotic symptoms in first-episode drug naïve (FEDN) MDDpatients. This study was to investigate the prevalence of psychotic symptoms and related risk factors in a large sample size of FEDN MDDpatients in a Chinese population. METHODS: A total of 573 patients with diagnosis of MDD at their first episode were recruited with their demographic and clinical data. Positive scale of the Positive and Negative Syndrome Scale was utilized for psychotic symptoms, Hamilton Anxiety Rating Scale (HAMA) for anxiety symptoms, and Hamilton Depression Rating Scale (HAMD) for depressive symptoms. RESULTS: The prevalence of psychotic symptoms in these MDDpatients was 9.8%. MDDpatients with psychotic symptoms had significantly higher HAMD and HAMA total scores than those without psychotic symptoms (both p < .001). A strong association was found between psychotic MDD and anxiety or suicide, with odds ratio of 33.097 for severe anxiety, and 5.012 for suicide. CONCLUSIONS: Our results suggest that psychotic symptoms are common in MDDpatients at their first episode. The strong association between psychotic MDD and anxiety or suicide attempts demonstrates the importance of reducing anxiety symptoms in the treatment of psychotic MDDpatients as well as the necessity to regularly assess suicide risk in MDDpatients with psychotic symptoms to better prevent suicidal behavior.