Depressive symptoms in schizophrenia

Objective: The authors assessed the presence and severity of depressive sym ptoms, as well as their associations with other clinical measures, in a gro up of mid- to late-life patients with schizophrenia who were not in a major depressive episode or diagnosed with schizoaffective disorder. Method: Six ty outpatients with schizophrenia between the ages of 45 and 79 years and 6 0 normal comparison subjects without major neuropsychiatric disorders, prop ortionally matched for age and gender, were studied. Depressive symptoms we re rated primarily with the Hamilton Depression Rating Scale. Standardized instruments were also used to measure global psychopathology, positive and negative symptoms, abnormalities of movement, and global cognitive status. Results: Depressive symptoms were more frequent and more severe in schizoph renic patients than in normal comparison subjects; 20% of the women with sc hizophrenia had a Hamilton depression scale score of 17 or more. Severity o f depressive symptoms correlated with that of positive symptoms but not wit h age, gender, negative symptoms, extrapyramidal symptoms, or neuroleptic d ose. Conclusions: Depressive symptoms are common in older patients with sch izophrenia. They may be an independent, core component of the disorder or, alternatively, may be a by-product of severe psychotic symptoms.