1
|
Migliorini C, Harvey C, Hou C, Wang S, Wang F, Huang ZH. Subjective quality of life and schizophrenia: results from a large cohort study based in Chinese primary care. BMC Psychiatry 2024; 24:86. [PMID: 38297269 PMCID: PMC10832280 DOI: 10.1186/s12888-024-05558-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 01/24/2024] [Indexed: 02/02/2024] Open
Abstract
INTRODUCTION Much confusion exists between health-related QoL (HRQoL) scales and subjective QoL (SQoL) scales. One method to avoid confusion is use of a single question that asks What is your quality of life? or similar. This study explored the relationship between biopsychosocial factors and high SQoL, SQoL stability, and factors associated with improving SQoL. METHOD We conducted a large cohort study of community-dwelling Chinese adults with schizophrenia, with two data points (2015-2016 (N = 742), 2017-2018 (N = 491)). Demographic and clinically related items and a comprehensive suite of published measures were collected. Direct logistic regressions were used to explore links between biopsychosocial factors and high SQoL and Improvement in SQoL across time. RESULTS Sample at Baseline: Male = 62.3%; Med age = 38.5 years; Med Age at illness onset = 24 years; SQoL Mode = neither poor nor good. Three independent variables predicted high SQoL at T1. Contemporary age and the presence of clinically relevant symptoms had a negative relationship with high SQoL; insight had a positive relationship with high SQoL. SQoL changed significantly across time with a modest effect size. Age at illness onset was the single independent variable linked to improving SQoL favoring being older at the time of illness onset. DISCUSSION/CONCLUSIONS SQoL can be high and changeable. While symptomology and illness insight may affect SQoL self-appraisals at single points in time, only age of illness onset was connected with improving SQoL. Thus, public health measures to delay illness onset are important. In addition, care about the distinction between HRQoL and SQoL in study design and choice of measures is necessary and will depend on the purpose and context.
Collapse
Affiliation(s)
- Christine Migliorini
- Psychosocial Research Centre, Department of Psychiatry, The University of Melbourne, Grattan St, Parkville, Victoria, 3010, Australia.
- Division of Mental Health, North West Area Mental Health, Melbourne, VIC, Australia.
- NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, VIC, Australia.
| | - Carol Harvey
- Psychosocial Research Centre, Department of Psychiatry, The University of Melbourne, Grattan St, Parkville, Victoria, 3010, Australia
- Division of Mental Health, North West Area Mental Health, Melbourne, VIC, Australia
| | - Cailan Hou
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences, Southern Medical University, Huifu West Road Yuexiu District, Guangdong, China
| | - Shibin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences, Southern Medical University, Huifu West Road Yuexiu District, Guangdong, China
| | - Fei Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences, Southern Medical University, Huifu West Road Yuexiu District, Guangdong, China
| | - Zhuo-Hui Huang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences, Southern Medical University, Huifu West Road Yuexiu District, Guangdong, China
| |
Collapse
|
2
|
Fang X, Wu Z, Wen L, Zhang Y, Wang D, Yu L, Wang Y, Chen Y, Chen L, Liu H, Tang W, Zhang X, Zhang C. Rumination mediates the relationship between childhood trauma and depressive symptoms in schizophrenia patients. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01525-2. [PMID: 36484845 DOI: 10.1007/s00406-022-01525-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/15/2022] [Indexed: 12/13/2022]
Abstract
Rumination and childhood trauma are related to depressive symptoms in clinical and non-clinical individuals. This is the first study aimed to test the mediating effect of rumination on the relationship between childhood trauma and depressive symptoms in schizophrenia patients. A total of 313 schizophrenia patients were recruited in the present study. The 17-item Hamilton Depression Rating Scale (HAMD-17) was adopted to evaluate depressive symptoms, the short-form Childhood Trauma Questionnaire (CTQ-SF) and the 10-item Ruminative response scale (RRS-10) were utilized to assess the childhood trauma and rumination in patients, respectively. Our results showed that 168 schizophrenia patients (53.67%) had comorbid depressive symptoms. These patients with depressive symptoms had higher levels of childhood trauma [both CTQ-SF total scores and emotional abuse (EA), emotional neglect (EN), physical neglect (PN) subscale scores] and rumination (both RRS-10 total scores and brooding, reflection subscale scores) compared to patients without depressive symptoms. The stepwise logistic regression analysis identified that EN (OR 1.196, P = 0.003), PN (OR 1.1294, P < 0.001), brooding (OR 1.291, P < 0.001) and reflection (OR 1.481, P < 0.001) could independently predict the depressive symptoms in schizophrenia patients. Moreover, RRS-10 and its subscale scores could mediate the relationship between depressive symptoms and childhood trauma, especially EA, EN and PN in schizophrenia. Our preliminary findings suggest that the rigorous assessment and psychosocial interventions of rumination are important to alleviate the influence of childhood trauma on depressive symptoms in schizophrenia patients.
Collapse
Affiliation(s)
- Xinyu Fang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Zenan Wu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Lu Wen
- Department of Psychiatry, The Second People's Hospital of Jiangning District, Nanjing, People's Republic of China
| | - Yaoyao Zhang
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Dandan Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Lingfang Yu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yewei Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yan Chen
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Lei Chen
- Department of Psychiatry, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Hongyang Liu
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Wei Tang
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.,Department of Psychiatry, School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China. .,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
3
|
He XY, Migliorini C, Huang ZH, Wang F, Zhou R, Chen ZL, Xiao YN, Wang QW, Wang SB, Harvey C, Hou CL. Quality of life in patients with schizophrenia: A 2-year cohort study in primary mental health care in rural China. Front Public Health 2022; 10:983733. [PMID: 36159297 PMCID: PMC9495714 DOI: 10.3389/fpubh.2022.983733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/17/2022] [Indexed: 01/25/2023] Open
Abstract
Objective Quality of life (QoL) has been always an important way to evaluate the outcomes of schizophrenia, but there have been few previous longitudinal studies and few in middle-income countries. This study aimed to explore the QoL in Chinese patients with schizophrenia treated in primary mental health care and the risk factors of QoL over time. Methods Patients with schizophrenia treated in primary mental health care in rural/regional areas in Luoding, Guangdong, PR China, were evaluated with an extended questionnaire including the Chinese version of the World Health Organization Quality of Life (WHOQOL-BREF) at baseline and 2-year follow-up. Bivariate and multivariate analyses were conducted including Generalized Estimated Equation analyses (GEE). Results Four hundred and ninety-one patients with schizophrenia in primary care completed the 2-year follow up evaluation. The QoL physical, environmental, and social relationships domains showed improvement after the 2-year period, but the psychological domain did not. GEE results showed that earlier age of onset, older age, being employed, being unmarried, the thicker waist circumference, less use of clozapine or other SGAs, fewer hospitalizations, more frequent insomnia, more severe depressive and negative symptoms as well as worse treatment insight were independently associated with poor QoL in patients with schizophrenia. Conclusion According to our results, to improve the quality of life of patients with schizophrenia in primary care, we should pay more attention to the treatment of depression, negative and insomnia symptoms of schizophrenia, the choice and dosage of antipsychotic medication and improvement in the treatment compliance. The combined use of educational and behavioral strategies may improve treatment adherence.
Collapse
Affiliation(s)
- Xiao-Yan He
- Liuzhou Worker's Hospital, Liuzhou, China,Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Center, Guangzhou, China
| | - Christine Migliorini
- Psychosocial Research Centre, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Zhuo-Hui Huang
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Center, Guangzhou, China
| | - Fei Wang
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Center, Guangzhou, China
| | - Rui Zhou
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Center, Guangzhou, China
| | | | | | - Qian-Wen Wang
- Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Shi-Bin Wang
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Center, Guangzhou, China
| | - Carol Harvey
- Psychosocial Research Centre, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Cai-Lan Hou
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Center, Guangzhou, China,*Correspondence: Cai-Lan Hou ;
| |
Collapse
|
4
|
Li P, Zhou M, Yan W, Du J, Lu S, Xie S, Zhang R. Altered resting-state functional connectivity of the right precuneus and cognition between depressed and non-depressed schizophrenia. Psychiatry Res Neuroimaging 2021; 317:111387. [PMID: 34509807 DOI: 10.1016/j.pscychresns.2021.111387] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 01/27/2023]
Abstract
The study investigated the resting-state functional connectivity (FC) and cognitive changes in patients with depressed schizophrenia(DS) and non-depressed schizophrenia(NDS). Eighty patients with first-episode schizophrenia and 50 healthy controls (HC) were included to conduct resting-state fMRI. All participants completed MATRICS Consensus Cognitive Battery (MCCB). The right precuneus was selected as the seed in whole-brain FC analysis. Our results showed the cognitive function (All MCCB dimensions) of all schizophrenia patients were worse than HC, but no differences were found between DS and NDS. The DS had decreased FC than NDS between the right precuneus and left middle cingulate gyrus, left cerebellum, right cerebellum. The DS had increased FC than HC between the right precuneus and temporal lobe, occipital lobe, and decreased FC between the right precuneus and left cerebellum. However, the NDS had increased FC than HC between the right precuneus and left cerebellum, right cerebellum, temporal lobe, occipital lobe, left superior parietal lobule. Correlation analysis showed that FC between the right precuneus and occipital lobe was negatively correlated with visual learning in DS and with social cognition in NDS. Our results suggest DS and NDS patients have different patterns of FC, and their FC changes correlate with different domains of cognition.
Collapse
Affiliation(s)
- Pingping Li
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Min Zhou
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Wei Yan
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Jinglun Du
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Shuiping Lu
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Shiping Xie
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China.
| | - Rongrong Zhang
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| |
Collapse
|
5
|
Husain MO, Chaudhry IB, Khan Z, Khoso AB, Kiran T, Bassett P, Husain MI, Upthegrove R, Husain N. Depression and suicidal ideation in schizophrenia spectrum disorder: a cross-sectional study from a lower middle-income country. Int J Psychiatry Clin Pract 2021; 25:245-251. [PMID: 34261408 DOI: 10.1080/13651501.2021.1914664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Depression has long been considered a significant feature of schizophrenia and is associated with more frequent psychotic episodes, increased service utilisation, substance misuse, poor quality of life and completed suicide. However, there is a distinct lack of literature on this comorbidity from low- and middle-income countries or non-western cultural backgrounds. METHODS This is a cross-sectional analysis of baseline data from a large randomised controlled trial, examining the prevalence of depression and suicidal ideation in patients with schizophrenia spectrum disorder. A total of 298 participants were recruited from inpatient and outpatient psychiatric units in Karachi, Pakistan. Participants completed the Calgary Depression Scale for Schizophrenia (CDSS), Positive and Negative Syndrome Scale (PANSS), Euro Qol (EQ-5D) and Social Functioning Scale (SFS). RESULTS Data indicate that 36% of participants in the study were depressed and 18% endorsed suicidal ideation. Depression was associated with higher positive symptom scores and reduced quality of life, but no significant difference in negative symptoms and social functioning. CONCLUSIONS Depression and suicidal ideation are prevalent in Pakistani patients diagnosed with schizophrenia spectrum disorder. Evaluation of depressive symptoms in this group may help identify individuals at higher risk of completed suicide, allowing for targeted interventions to improve outcomes.Key pointsTo our knowledge, this is the first study describing the prevalence of depression and suicidal ideation in individuals with schizophrenia from Pakistan.Our data indicate that 36% of individuals with schizophrenia in our sample were depressed and 18% endorsed suicidal ideation.Depression in schizophrenia was associated with poorer quality of life and higher positive symptom burden.This study adds to the scarce literature from low- and middle-income countries where the burden of mental illness is great and where the majority of suicide deaths occur.Addressing social inequality, food insecurity, high rates of unemployment and low levels of literacy in these settings may have a profound effect on population mental health and suicide risk.
Collapse
Affiliation(s)
- M Omair Husain
- Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Pakistan Institute of Living and Learning, Karachi, Pakistan.,Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Imran B Chaudhry
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK.,Department of Psychiatry, Ziauddin Hospital, Karachi, Pakistan
| | - Zainib Khan
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Ameer B Khoso
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Tayyeba Kiran
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | | | - M Ishrat Husain
- Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Nusrat Husain
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| |
Collapse
|
6
|
Xi SJ, Shen MX, Wang Y, Zhou W, Xiao SY, Tebes JK, Yu Y. Depressive symptoms, anxiety symptoms, and their co-occurrence among people living with schizophrenia in China: Prevalence and correlates. J Clin Psychol 2021; 77:2137-2146. [PMID: 34212382 DOI: 10.1002/jclp.23141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/26/2021] [Accepted: 03/28/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND The current study examines the prevalence of depressive symptoms, anxiety symptoms, their occurrence, and key socio-demographic and clinical correlates among people living with schizophrenia. METHODS A cross-sectional study was conducted on 390 schizophrenia individuals. Depressive and anxiety symptoms, patient symptoms, functioning, and disability were assessed using standard assessment tools. RESULTS People living with schizophrenia had a prevalence of 40.51% for depressive symptoms, 29.74% for anxiety symptoms, and 26.41% for their co-occurrence. More symptoms (odds ratio [OR]: 1.04-1.06, 95% confidence interval [CI]: 1.01-1.10) and higher disability (OR: 1.06, 95% CI: 1.03-1.09) were associated with increased risk of depressive symptoms, anxiety symptoms, and their co-occurrence. In addition, having middle school or high school education (OR: 2.48-2.61, 95% CI: 1.15-5.53), and being unemployed (OR: 4.98-9.08, 95% CI: 1.09-69.87) were associated with increased risk for anxiety symptoms and its co-occurrence with depressive symptoms. CONCLUSIONS Depressive and anxiety symptoms are relatively common. Interventions should carefully assess these symptoms to distinguish them from schizophrenia to target them in the treatment.
Collapse
Affiliation(s)
- Shi-Jun Xi
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Min-Xue Shen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yao Wang
- Department of Midwifery, Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Wei Zhou
- Research Center for Public Health and Social Security, School of Public Administration, Hunan University, Changsha, Hunan, China
| | - Shui-Yuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jacob Kraemer Tebes
- Department of Psychiatry, Division of Prevention and Community Research, Yale School of Medicine, New Haven, Connecticut, USA
| | - Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.,Department of Psychiatry, Division of Prevention and Community Research, Yale School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
7
|
Association of depressive symptoms with cognitive impairment in patients with never-treated first-episode schizophrenia: Analysis of the Depression in Schizophrenia in China (DISC) study. Gen Hosp Psychiatry 2021; 71:108-113. [PMID: 34000518 DOI: 10.1016/j.genhosppsych.2021.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/25/2021] [Accepted: 04/29/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Depressive symptoms and cognitive dysfunction are common in patients with schizophrenia and depressive disorder. This study aimed at exploring whether and how depressive symptoms were correlated with neuro-cognitive impairment in patients with never-treated first-episode (NTFE) schizophrenia. METHODS The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was administered to 79 patients and 80 healthy controls to assess neuropsychological function. For all patients, the 17-item Hamilton Depression Rating Scale (HAMD-17) was adopted to evaluate depressive symptoms, and the Positive and Negative Syndrome Scale (PANSS) was utilized to assess psychopathological symptoms. RESULTS Thirty-nine patients (49.37%) met the criteria for comorbid depressive symptoms. The RBANS total and the four index scores in the patients were significantly lower than those in the healthy controls. Further, compared with patients without depressive symptoms, patients with depressive symptoms scored lower in attention index, but higher in PANSS general psychopathology and total scores. The HAMD-17 total score was significantly correlated with attention, PANSS total, and PANSS general psychopathology scores. Moreover, multiple regression analysis identified education and HAMD-17 score as the contributors to attention. CONCLUSION Our results suggest that the rate of depressive symptoms in NTFE schizophrenia is high, which is correlated with neuro-cognitive impairment, especially attention and psychopathology.
Collapse
|
8
|
Lange SMM, Schirmbeck F, Stek ML, Murk Jansen YR, van Rooijen G, de Haan L, Penninx BWJH, Rhebergen D. A comparison of depressive symptom profiles between current major depressive disorder and schizophrenia spectrum disorder. J Psychiatr Res 2021; 135:143-151. [PMID: 33486162 DOI: 10.1016/j.jpsychires.2021.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/03/2020] [Accepted: 01/04/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Depressive symptoms are highly prevalent and clinically relevant in schizophrenia spectrum disorder (SSD) patients. So far, little is known about to what extent the depressive symptom profile in SSD is comparable to that seen in major depressive disorder (MDD). METHODS Data were derived from the Genetic Risk and Outcome of Psychosis study (GROUP) and the Netherlands Study of Depression and Anxiety (NESDA). We examined differences in severity of depressive symptom profiles and distribution of mood/cognition and somatic/vegetative depressive symptoms using the Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR) within SSD patients (n = 449), MDD patients (n = 816) and healthy controls (n = 417), aged 18 to 50. Within SSD, associations between depression severity and clinical and demographic data were examined. RESULTS 60.4% of SSD patients showed substantial depressive symptomatology (QIDS-SR≥6). The difference in mood/cognition symptoms between SSD and MDD was larger (higher symptoms in MDD, effect size = 1.13), than the differences in somatic/vegetative symptoms (effect size 0.74). In patients with SSD, multivariable regression analyses showed that lower social functioning, male gender, use of benzodiazepine and more severe positive symptoms were associated with higher overall depressive symptomatology. The use of antipsychotics or antidepressants was associated with more somatic/vegetative symptoms. CONCLUSION More than half of SSD patients have considerable depressive symptomatology, with a relative preponderance of somatic/vegetative symptoms compared to the profile seen in MDD. Future research could explore whether depressive symptom profile in SSD may also be associated with biological dysregulations like in MDD.
Collapse
Affiliation(s)
- Sjors M M Lange
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, and GGZ InGeest, Amsterdam, the Netherlands.
| | - Frederike Schirmbeck
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Max L Stek
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, and GGZ InGeest, Amsterdam, the Netherlands
| | - Yentl R Murk Jansen
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, and GGZ InGeest, Amsterdam, the Netherlands
| | - Geeske van Rooijen
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Lieuwe de Haan
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Brenda W J H Penninx
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, and GGZ InGeest, Amsterdam, the Netherlands
| | - Didi Rhebergen
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, and GGZ InGeest, Amsterdam, the Netherlands
| | | |
Collapse
|
9
|
Liu R, Fang X, Yu L, Wang D, Wu Z, Guo C, Teng X, Ren J, Zhang C. Gender Differences of Schizophrenia Patients With and Without Depressive Symptoms in Clinical Characteristics. Front Psychiatry 2021; 12:792019. [PMID: 35095605 PMCID: PMC8792946 DOI: 10.3389/fpsyt.2021.792019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives: To investigate the differences in psychotic symptoms and cognitive function in schizophrenics with and without depression and to compare gender differences in the correlation between depressive symptoms and clinical characteristics in those patients. Methods: A total of 190 schizophrenia patients and 200 healthy controls were recruited in the study. We used the Positive and Negative Symptom Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to evaluate the psychiatric symptoms, depressive symptoms and cognitive function, respectively. Patients with CDSS score ≥7 were divided into depression group, and CDSS < 7 was viewed as without depression. Results: Patients with schizophrenia had lower total scores of RBANS and five subscale (immediate memory, visual span, verbal function, attention, and delayed memory) scores compared to healthy controls. In the case group, patients who concomitant with depression had higher PANSS scores (Ps < 0.001) and lower RBANS (Ps < 0.05) scores than those without depression. After gender stratification, PANSS total scores and subscale scores were significantly different between schizophrenics with and without depressive symptoms in both male and female groups (Ps < 0.001). For cognitive function, there were significant differences in RBANS total score and subscale scores except attention between female patients with and without schizophrenia but not in male schizophrenia patients. Furthermore, the correlation analysis showed that the total CDSS score was positively correlated with PANSS score (P < 0.001) and RBANS score in male and female groups (male: P = 0.010, female: P = 0.001). Conclusion: Our findings provided evidence supporting the gender differences in psychiatric symptoms and cognitive function between schizophrenia patients with and without depressive symptoms.
Collapse
Affiliation(s)
- Ruimei Liu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyu Fang
- Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Lingfang Yu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dandan Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zenan Wu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chaoyue Guo
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyue Teng
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juanjuan Ren
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
10
|
Pazoki R, Lin BD, van Eijk KR, Schijven D, de Zwarte S, Guloksuz S, Luykx JJ. Phenome-wide and genome-wide analyses of quality of life in schizophrenia. BJPsych Open 2020; 7:e13. [PMID: 33295273 PMCID: PMC7791571 DOI: 10.1192/bjo.2020.140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Schizophrenia negatively affects quality of life (QoL). A handful of variables from small studies have been reported to influence QoL in patients with schizophrenia, but a study comprehensively dissecting the genetic and non-genetic contributing factors to QoL in these patients is currently lacking. AIMS We adopted a hypothesis-generating approach to assess the phenotypic and genotypic determinants of QoL in schizophrenia. METHOD The study population comprised 1119 patients with a psychotic disorder, 1979 relatives and 586 healthy controls. Using linear regression, we tested >100 independent demographic, cognitive and clinical phenotypes for their association with QoL in patients. We then performed genome-wide association analyses of QoL and examined the association between polygenic risk scores for schizophrenia, major depressive disorder and subjective well-being and QoL. RESULTS We found nine phenotypes to be significantly and independently associated with QoL in patients, the most significant ones being negative (β = -1.17; s.e. 0.05; P = 1 × 10-83; r2 = 38%), depressive (β = -1.07; s.e. 0.05; P = 2 × 10-79; r2 = 36%) and emotional distress (β = -0.09; s.e. 0.01; P = 4 × 10-59, r2 = 25%) symptoms. Schizophrenia and subjective well-being polygenic risk scores, using various P-value thresholds, were significantly and consistently associated with QoL (lowest association P-value = 6.8 × 10-6). Several sensitivity analyses confirmed the results. CONCLUSIONS Various clinical phenotypes of schizophrenia, as well as schizophrenia and subjective well-being polygenic risk scores, are associated with QoL in patients with schizophrenia and their relatives. These may be targeted by clinicians to more easily identify vulnerable patients with schizophrenia for further social and clinical interventions to improve their QoL.
Collapse
Affiliation(s)
- Raha Pazoki
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands; and Department of Epidemiology, Imperial College London, School of Public Health, UK
| | - Bochao Danae Lin
- Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kristel R van Eijk
- Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Dick Schijven
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; and Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Sonja de Zwarte
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands; and Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jurjen J Luykx
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands; Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands; and Outpatient Second Opinion Clinic, GGNet, Warnsveld, The Netherlands
| |
Collapse
|
11
|
Demirkol ME, Tamam L, Namlı Z, Uğur K, Karaytuğ MO. The Mediating Effect of Depression and Disability in the Relationship Between Schizophreniaand Self-Esteem. Psychiatr Q 2020; 91:363-378. [PMID: 31912456 DOI: 10.1007/s11126-019-09706-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Depressive symptoms, in addition to positive and negative symptoms, are commonly observed in the course of schizophrenia. These symptoms may cause disability and reduced self-esteem. Disability and lower self-esteem may disrupt the quality of life and lead to social isolation. Demonstrating the relationships among these concepts and correcting possible disturbances may help to augment treatment compliance and improve the prognosis. In this study, the Calgary Depression Scale for Schizophrenia (CDSS), the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), the World Health Organization Disability Assessment Schedule 2.0 (WHODAS), and the Rosenberg Self Esteem Scale (RSES) were applied along with a sociodemographic data form to 146 patients with schizophrenia. Path analyses were used to demonstrate the direct effect of schizophrenia severity on self-esteem and its indirect effect through disability and depression, the mediating effect of depression in the relationship between schizophrenia severity and disability, and the mediator effect of disability in the bidirectional relationship between self-esteem and depression. Statistically significant results were obtained. In multivariate regression analysis, significant effects on disability were demonstrated for PANSS General Psychopathology subscale, CDSS, and RSES. These data suggest that attention should be focused on concepts such as depression, disability, and self-esteem in schizophrenia patients.
Collapse
Affiliation(s)
- Mehmet Emin Demirkol
- Department of Psychiatry, Çukurova University Medical School, Psikiyatri Anabilim Dalı, Çukurova Üniversitesi Tıp Fakültesi Balcalı Hastanesi 01330 Sarıçam, Adana, Turkey
| | - Lut Tamam
- Department of Psychiatry, Çukurova University Medical School, Psikiyatri Anabilim Dalı, Çukurova Üniversitesi Tıp Fakültesi Balcalı Hastanesi 01330 Sarıçam, Adana, Turkey.
| | - Zeynep Namlı
- Department of Psychiatry, Şanlıurfa Mehmet Akif Inan State Hospital, Şanlıurfa, Turkey
| | - Kerim Uğur
- Department of Psychiatry, Malatya Training and Research Hospital, Malatya, Turkey
| | - Mahmut Onur Karaytuğ
- Department of Psychiatry, Dr Ekrem Tok Hospital for Mental and Nervous Disesase, Adana, Turkey
| |
Collapse
|
12
|
Sommer IE, Tiihonen J, van Mourik A, Tanskanen A, Taipale H. The clinical course of schizophrenia in women and men-a nation-wide cohort study. NPJ SCHIZOPHRENIA 2020; 6:12. [PMID: 32358572 PMCID: PMC7195359 DOI: 10.1038/s41537-020-0102-z] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/12/2020] [Indexed: 11/09/2022]
Abstract
Gender differences in schizophrenia have been reported in different aspect of the course of disease and may urge special clinical interventions for female patients. Current literature provides insufficient information to design guidelines for treating women with schizophrenia. We aim to quantify the clinical course of schizophrenia in men and women on premorbid hospitalizations and prescription drugs, age at diagnosis, pharmacological treatment, comorbidity, number of re-hospitalizations, and mortality. Our nationwide cohort study included all patients admitted for the first time to hospital during 2000-2014 for schizophrenia or schizo-affective disorder in Finland. Gender differences were compared with logistic regression, by calculating incidence rates, and mortality was assessed with Cox proportional hazard model. We included 7142 women and 9006 men with schizophrenia/schizo-affective disorder and found that both women (71%) and men (70%) had often been hospitalized for another psychiatric disorder in the 5 years before diagnosis. In women, the last psychiatric hospitalization before schizophrenia/schizo-affective diagnosis was often for mood disorders (62%, OR 2.56, 95% CI 2.28-2.87). Men were diagnosed earlier (mean 34.4 [SD12.6] vs. 38.2 [SD 13.8]) with peak incidence around 22, while incidence in women declining only slowly between age 18 and 65. During ten years follow-up, 69.5% of both genders needed at least one re-hospitalization, with slightly more hospitalizations in women. Women were less often prescribed clozapine or long-acting antipsychotics. Mortality was lower in women (HR = 0.54, 95% CI 0.50-0.60), with fewer suicide and cardiovascular deaths, but more cancer deaths. These results suggest a diagnostic delay for women, which might be shortened by screening women aged 20-65 participating in affective disorder programs. As number of hospitalizations is not lower for women, clinicians should take care not to undertreat women with schizophrenia.
Collapse
Affiliation(s)
- Iris E Sommer
- Rijksuniversiteit Groningen (RUG), University Medical Center Groningen (UMCG), Department of Biomedical Sciences of Cells and Systems, Groningen, Netherlands.
| | - Jari Tiihonen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
- Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden
| | - Anouk van Mourik
- Rijksuniversiteit Groningen (RUG), University Medical Center Groningen (UMCG), Department of Biomedical Sciences of Cells and Systems, Groningen, Netherlands
| | - Antti Tanskanen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
| | - Heidi Taipale
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| |
Collapse
|
13
|
Zhou C, Kong D, Zhu X, Wu W, Xue R, Li G, Xu Y, Liu S, Tian H, Zhuo C. Rethinking Schizophrenia and Depression Comorbidity as One Psychiatric Disorder Entity: Evidence From Mouse Model. Front Neurosci 2020; 14:115. [PMID: 32218718 PMCID: PMC7078335 DOI: 10.3389/fnins.2020.00115] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/29/2020] [Indexed: 01/27/2023] Open
Abstract
Schizophrenia is frequently accompanied by depressive symptoms, but the pathological mechanisms remain to be elucidated. In this study, we used chronic unpredicted mild stress plus MK801 injection to generate a mouse model of schizophrenia with depression, in which in vivo 2-photon calcium imaging and electrophysiological recordings were performed in conjunction with behavioral phenotyping. Compared to mice models with classical depression or to schizophrenia models, the animal models with schizophrenia and depression comorbidity presented worse psychotic and depressive symptoms. These behavioral deficits are associated with impaired neuronal calcium activities in the frontal cortex and thalamic nuclei. Moreover, in sharp contrast to classical models that have a satisfactory response to antipsychotic or antidepressant drugs, this novel schizophrenia with depression model is resilient to combined drug treatment in terms of behavioral and functional recovery. Taken together, these data indicate that schizophrenia with depression likely involves a unique pathophysiology that is different from schizophrenia or depression alone.
Collapse
Affiliation(s)
- Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Dezhi Kong
- Two-Photon In Vivo Imaging Centre, Institute of Chinese Integrative Medicine, Hebei Medical University, Shijiazhuang, China
| | - Xiaodong Zhu
- Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Wu
- Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Rong Xue
- Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Gongying Li
- Institute of Brain Micro Scale Imaging Centre, School of Mental Health, Jining Medical University, Jining, China
| | - Yong Xu
- MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Sha Liu
- MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Hongjun Tian
- Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory (PNGC_Lab), Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, China
| | - Chuanjun Zhuo
- Institute of Brain Micro Scale Imaging Centre, School of Mental Health, Jining Medical University, Jining, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory (PNGC_Lab), Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, China
| |
Collapse
|
14
|
Fanta T, Bekele D, Ayano G. The prevalence and associated factors of depression among patients with schizophrenia in Addis Ababa, Ethiopia, cross-sectional study. BMC Psychiatry 2020; 20:3. [PMID: 31898508 PMCID: PMC6941238 DOI: 10.1186/s12888-019-2419-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 12/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is common among people with schizophrenia and associated with severe positive and negative symptoms, higher rates of disability, treatment resistance and mortality related to suicide, physical and drug-related causes. However, to our knowledge, no study has been conducted to report the magnitude of depression among people with schizophrenia in Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of depression among people with schizophrenia. METHOD A hospital-based cross-sectional study was conducted among 418 patients with schizophrenia selected by systematic sampling technique. Patient Health Questionnaire 9 (PHQ-9) was used to measure depression among the study participants. To identify the potential contributing factors, we performed binary and multivariable logistic regression analysis adjusting the model for the potential confounding factors. Odds ratios (OR) with the corresponding 95% confidence interval (95%CI)) was determined to evaluate the strength of association. RESULT The prevalence estimate of depression among people with schizophrenia was found to be 18.0% [95% confidence interval: 14.50-22.30]. Our multivariable analysis revealed that current substance use (AOR 2.28, 95%CI (1.27, 4.09), suicide attempt (AOR 5.24, 95%CI (2.56, 10.72), duration of illness between 6 and 10 years (AOR 2.09, 95%CI (1.08, 4.04) and poor quality of life (AOR 3.13, 95%CI (1.79, 5.76) were found to be the factors associated with depression among people with schizophrenia. CONCLUSION The current study revealed that comorbid depression was high among people with schizophrenia and associated with current substance use, suicide attempt, and long duration of the illness as well as poor quality of life. Attention needs to be given to address comorbid depression among people with schizophrenia.
Collapse
Affiliation(s)
- Tolesa Fanta
- Research and training department, Amanuel mental specialized hospital, Po Box 1971, Addis Ababa, Ethiopia.
| | - Desalegn Bekele
- 0000 0001 1250 5688grid.7123.7Department of psychiatry, Addis Ababa University, Addis Ababa, Ethiopia
| | - Getinet Ayano
- Research and training department, Amanuel mental specialized hospital, Po Box 1971, Addis Ababa, Ethiopia
| |
Collapse
|
15
|
Wang TT, Beckstead JW, Yang CY. Social interaction skills and depressive symptoms in people diagnosed with schizophrenia: The mediating role of auditory hallucinations. Int J Ment Health Nurs 2019; 28:1318-1327. [PMID: 31433115 DOI: 10.1111/inm.12643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 07/09/2019] [Accepted: 07/16/2019] [Indexed: 11/30/2022]
Abstract
Past studies have presented evidence that depressive symptoms are affected in different ways by social interaction skills and auditory hallucinatory symptoms in people with schizophrenia. However, few studies have focused on examining the relationship among auditory hallucinatory severity, social interaction skills, and depressive symptoms. This study aimed to explore the mediating effect of auditory hallucinatory severity on social interaction skills and depressive symptoms in people with long-term schizophrenia. We propose that auditory hallucination severity functions as a mechanism through which impaired social interaction skills increase depressive symptoms. In this study, a convenience sample of 186 people with schizophrenia was obtained from hospital-based rehabilitation wards. Four instruments were used: A demographic data questionnaire, the Assessment of Communication and Interaction Skills-Chinese version, the Characteristics of Auditory Hallucinations Questionnaire, and the Beck Depression Inventory II. To investigate the mediating effect of auditory hallucinatory severity after controlling for six covariates, we tested an indirect effect in a simple mediation model using the SPSS macro PROCESS, which is a regression-based approach. The indirect effect and the results of Sobel's test were significant (Z = -2.824, P = 0.005), which confirms that auditory hallucination severity mediates social interaction skills and depressive symptoms. This finding suggests that psychiatric nurses must teach people with schizophrenia to use auditory hallucination management strategies to prevent them from becoming immersed in auditory hallucinations and reducing their social interaction with the real world, so that depressive symptoms can be improved.
Collapse
Affiliation(s)
- Tzu-Ting Wang
- School of Nursing National Yang-Ming University, Taipei, Taiwan.,Cardinal Tien Junior College of Healthcare & Management, New Taipei City, Taiwan
| | - Jason W Beckstead
- College of Public Health, Epidemiology and Biostatistics, University of South Florida, Tampa, Florida, USA
| | - Chiu-Yueh Yang
- School of Nursing, National Yang Ming University, Taipei, Taiwan.,Department of Nursing, National Yang-Ming University Hospital, Yilan, Taiwan
| |
Collapse
|
16
|
Fang X, Chen L, Wang D, Yu L, Wang Y, Chen Y, Ren J, Tang W, Zhang C. Metabolic profiling identifies TC and LDL as potential serum biomarkers for depressive symptoms in schizophrenia. Psychiatry Res 2019; 281:112522. [PMID: 31521045 DOI: 10.1016/j.psychres.2019.112522] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 01/25/2023]
Abstract
This study aimed to explore the relationship between serum levels of cardiometabolic biomarkers and depressive symptoms in schizophrenia patients treated with atypical antipsychotics. A total of 210 patients with schizophrenia and 70 healthy controls were recruited in our present study. All patients were rated on the 17-item Hamilton Depression Rating Scale (HAMD-17) to measure depressive symptoms and the Positive and Negative Syndrome Scale (PANSS) for psychopathology. Serum cardiometabolic biomarkers (HDL, LDL, TC, TG, GLU) in all participants were measured. Our results showed that schizophrenia patients had higher levels of serum GLU, TG, TC, LDL and BMI, but lower levels of HDL than controls (all P < 0.05). Compared to patients without depressive symptoms, those with depressive symptoms showed higher PANSS total, general psychopathology, positive and negative symptom scores (all p < 0.05), as well as higher serum levels of LDL (p < 0.001) and TC (p = 0.011). In addition, our correlation analysis showed that serum LDL (P < 0.001) and TC (P = 0.045) levels were positively associated with HAMD total scores in schizophrenia patients after age, sex and education levels were controlled. Our results suggest the appearance of depression in schizophrenia patients may be associated with high levels of metabolic parameters, especially TC and LDL.
Collapse
Affiliation(s)
- Xinyu Fang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lixian Chen
- The Second People's Hospital of Yuhuan, Zhejiang, China
| | - Dandan Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lingfang Yu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yewei Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yan Chen
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Juanjuan Ren
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Wei Tang
- Wenzhou Kangning Hospital, Wenzhou Medical University, Zhejiang, China
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| |
Collapse
|
17
|
Xu YM, Li F, Liu XB, Zhong BL. Depressive symptoms in Chinese male inpatients with schizophrenia: Prevalence and clinical correlates. Psychiatry Res 2018; 264:380-384. [PMID: 29677621 DOI: 10.1016/j.psychres.2018.04.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 04/03/2018] [Accepted: 04/04/2018] [Indexed: 11/17/2022]
Abstract
Depression is common in patients with schizophrenia and associated with serious consequences. However, previous studies have mixed findings on characteristics of depression in schizophrenia, partly because of the use of depressive symptom scales that are not specific to schizophrenia. This study examined the prevalence and correlates of depressive symptoms in Chinese patients with schizophrenia. A consecutive sample of 349 male inpatients with schizophrenia was recruited from the largest psychiatric specialty hospital in south-central China. Depressive symptoms and psychopathology of patients were assessed with the Calgary Depression Scale for Schizophrenia and the Positive and Negative Symptom Scale, respectively. Extrapyramidal side effects (EPSs) were assessed with the Simpson Angus Scale, the Barnes Akathisia Rating Scale, and the Abnormal Involuntary Movement Scale. Demographic and other clinical data were also collected. Depressive symptoms were present in 41.8% of male schizophrenia inpatients. Multiple logistic regression analysis revealed that early age at onset (OR [95%CI] = 1.12 [1.01,1.27], p = 0.049), more severe negative symptoms (OR [95%CI] = 1.05 [1.01,1.09], p = 0.034), more severe general psychopathological symptoms (OR [95%CI] = 1.06 [1.01,1.12], p = 0.041), akathisia (OR [95%CI] = 2.87 [1.45,5.69], p = 0.003), and dyskinesia (OR [95%CI] = 3.93 [1.36,11.33], p = 0.011) were significantly associated with depression. Appropriate antipsychotic medication treatment and reducing EPSs of antipsychotics may help prevent or relieve depression of patients with schizophrenia.
Collapse
Affiliation(s)
- Yan-Min Xu
- Affiliated Wuhan Mental Health Center (The Ninth Clinical School), Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China
| | - Fu Li
- Affiliated Wuhan Mental Health Center (The Ninth Clinical School), Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China
| | - Xiao-Bo Liu
- Affiliated Wuhan Mental Health Center (The Ninth Clinical School), Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China
| | - Bao-Liang Zhong
- Affiliated Wuhan Mental Health Center (The Ninth Clinical School), Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China.
| |
Collapse
|
18
|
Dai J, Du X, Yin G, Zhang Y, Xia H, Li X, Cassidy R, Tong Q, Chen D, Teixeira AL, Zheng Y, Ning Y, Soares JC, He MX, Zhang XY. Prevalence, demographic and clinical features of comorbid depressive symptoms in drug naïve patients with schizophrenia presenting with first episode psychosis. Schizophr Res 2018; 193:182-187. [PMID: 28651908 DOI: 10.1016/j.schres.2017.06.029] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 06/17/2017] [Accepted: 06/18/2017] [Indexed: 01/04/2023]
Abstract
Depressive symptoms are common in first episode schizophrenia. However, the prevalence and its associations of comorbid depressive symptoms with clinical variables are less well characterized in Chinese Han patients with schizophrenia. In this cross-sectional study, we recruited 240 first-episode and drug naïve (FEDN) inpatients with schizophrenia. All patients were rated on the 17-item Hamilton Depression Rating Scale (HAMD-17) to measure depressive symptoms, and also on the Positive and Negative Syndrome Scale (PANSS) for psychopathology. Our results showed that 131 patients had a total score of 8 or more points on HAMD-17, making the prevalence of comorbid depressive symptoms 54.6%. Fewer women (48.1%, 62 of 129) than men (62.2%, 69 of 111) had comorbid depressive symptoms. Compared to those patients without depressive symptoms, those with depressive symptoms showed higher PANSS total, general psychopathology, cognitive factor and negative symptom scores (all p<0.05). Further stepwise multiple logistic regression analysis indicated that the PANSS general psychopathology, the PANSS total score and gender (all p<0.05) remained significantly associated with depressive symptoms. In addition, correlation analysis showed significant correlations between HAMD total score and the following parameters: the PANSS general psychopathology, total score, and cognitive factor (Bonferroni corrected p's<0.05). Our results suggest that depressive symptoms occur with high prevalence in FEND schizophrenia in a Chinese Han population, and show association with general psychopathology, as well as with cognitive impairment.
Collapse
Affiliation(s)
- Jing Dai
- The Fourth People's Hospital of Chengdu, Chengdu Mental Health Center, Chengdu, China
| | - Xiangdong Du
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Guangzhong Yin
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Yingyang Zhang
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Haishen Xia
- Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China
| | - Xiaosi Li
- Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, China
| | - Rylan Cassidy
- Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases of McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Qingchun Tong
- Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases of McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dachun Chen
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Antonio Lucio Teixeira
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Yingjun Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Man-Xi He
- The Fourth People's Hospital of Chengdu, Chengdu Mental Health Center, Chengdu, China.
| | - Xiang Yang Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
| |
Collapse
|
19
|
Li Y, Hou CL, Ma XR, Zhong BL, Zang Y, Jia FJ, Lin YQ, Lai KYC, Chiu HFK, Ungvari GS, Hall BJ, Cai MY, Ng CH, Xiang YT. Quality of life in Chinese patients with schizophrenia treated in primary care. Psychiatry Res 2017; 254:80-84. [PMID: 28456026 DOI: 10.1016/j.psychres.2017.04.049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/26/2017] [Accepted: 04/23/2017] [Indexed: 11/17/2022]
Abstract
In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians. This study examined the quality of life (QOL) in patients with schizophrenia treated in primary care and explored the demographic and clinical characteristics associated with QOL. Altogether, 612 patients with schizophrenia treated in 22 randomly selected primary care services in China formed the study sample. QOL, psychotic and depressive symptoms, extra-pyramidal symptoms and insight were assessed using standardized instruments. Data analyses were conducted with the one sample t-test and multiple linear regression analyses. Compared with the normative data for the Chinese general population, significantly lower scores in physical and mental QOL domains were found in the patient group. Older age, being unemployed, major medical conditions, no smoking, more severe depressive and negative symptoms, more frequent insomnia, and suicidality were independently associated with poor physical QOL. Male gender, more severe depressive and anxiety symptoms, more frequent insomnia, and suicidality were independently associated with poor mental QOL. Patients with schizophrenia treated in primary care had lower level of QOL in comparison with general population. Effective measures need to be implemented to improve their QOL.
Collapse
Affiliation(s)
- Yan Li
- The National Clinical Research Center for Mental Disorders, China & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China; Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Xin-Rong Ma
- Ningxia Mental Health Center, Ningxia Ning-An Hospital, Ningxia Province, China
| | - Bao-Liang Zhong
- The Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Yu Zang
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China.
| | - Yong-Qiang Lin
- Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Kelly Y C Lai
- Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Helen F K Chiu
- Department of Psychiatry, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Marian Centre, Perth, Australia; School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Brian J Hall
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macao SAR, China; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mei-Ying Cai
- Guangzhou Yuexiu Center for Disease Control and Prevention, Guangdong Province, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| |
Collapse
|