Abstract
Objective. The aim of the study was an analysis of the frequency and course of depressive symptoms in Polish patients with the first episode of schizophrenia and an assessment of treatment results.
Methods. The study included 94 patients with the first episode of schizophrenia allocated in a randomized fashion to the treatment with low dose haloperidol (n=26), amisulpride (n=27), olanzapine (n=26), quetiapine (n=12) or ziprasidone (n=3), for the period of 12 months. Depressive symptoms were assessed using the Calgary Depression Scale for Schizophrenia (CDSS) at baseline, and then after 1, 3, 6 and 12 months.
Results. At baseline, depressive symptoms with the score of >6 on CDSS were found in 44.7% of cases. The mean intensity of these symptoms was slightly lower than in other Polish studies on patients with the first episode of schizophrenia but similar as in the whole EUFEST group. Patients with depressive symptoms were younger and had lower quality of life as assessed by MANSA. Otherwise, no relationship was found between the intensity of depressive symptoms and selected demographic parameters, intensity of psychopathology measured by PANSS and improvement after treatment. Antidepressant drugs were added to antipsychotic treatment three times more frequently in Polish group compared with the whole EUFEST group, SSRIs being used in >90% of the cases. The reduction of depressive symptoms was similar in the group receiving antidepressant treatment as in the group without such treatment.
Conclusion. Depressive symptoms are frequent among patients with the first episode of schizophrenia and usually improve with antipsychotic treatment. No significant differences were found between antipsychotic drugs studied in their efficacy against depressive symptoms. In Polish patients, antidepressant drugs were used very frequently (mainly SSRIs) as an addition to antipsychotic treatment. A favorable prognostic value of depressive symptoms occurring in the early
stages of schizophrenia was not confirmed.