Prevalence and clinical correlates of depression in the acute phase of first episode schizophrenia

Background: Reported rates of depression in schizophrenia vary considerably. Objective: To measure the prevalence of depression in a first episode sample of people with schizophrenia. Methods: All referrals with a first episode of schizophrenia diagnosed using SCID interviews were assessed pre-discharge and again six months later. We used the Calgary Depression Scale for Schizophrenia (CDSS) and Positive and Negative Syndrome Scale (PANSS) to assess the severity of symptoms. Results: Pre-discharge, 10.4% of the sample met CDSS criteria for depression. According to the PANSS depression (PANSS –D) subscale, 3% of patients were depressed, with a mean score of 7.48 (SD = 2.97). Only 3% of patients pre-discharge were found to be depressed on both the CDSS and the PANSS-D. Six months later 6.5% were depressed according to the CDSS. However none reached depression criteria according to the PANSS-D. The CDSS correlated with PANSS-D both pre-discharge and at follow-up. Feelings of depression and self-deprecation were the most common symptoms at baseline and follow-up. The CDSS was unrelated to negative symptoms at both stages. A lifetime history of alcohol abuse increased the risk for depression. Conclusion: Rates of depression in this sample were low. The CDSS appears to discriminate between depression and negative symptoms. Like the general population, alcohol misuse is a risk factor for depression in first episode schizophrenia