Depression in schizophrenia: Recognition and management in the USA

The recognition of depression as a distinct syndrome within schizophrenia i s a relatively recent development. The International Survey of Depression i n Schizophrenia was designed to evaluate current clinical practice and pres cribing trends in the management of the depressive component of schizophren ia. A 48-item questionnaire, comprising fixed-response questions and questions stimulated by case scenarios, was distributed to 37 513 psychiatrists in th e USA. A total of 43 484 psychiatrists in Canada, Australia and 21 European countr ies also received the questionnaire. A total of 1128 US psychiatrists respo nded. Analysis of the data revealed that US psychiatrists: identify symptom s of depression in approximately one-third of patients with schizophrenia, and largely appreciate the magnitude of the resultant burden on patients an d their families. Responses to questions regarding treatment approaches and case scenarios demonstrated that the level of adjunctive prescribing of an tidepressants in the USA is often higher than in other regions. Levels of awareness of depression in patients with schizophrenia and recogn ition of the need for effective management appear to be high among US psych iatrists. However, more than a quarter of these specialists rarely or never prescribe adjunctive antidepressant medications. Disparities: in treatment approaches varying from the existing scientific evidence base underscore t he need for further investigation into ways: of optimizing the management o f this serious coexisting condition. (C) 2001 Elsevier Science B.V. All rig hts reserved.