Life events can trigger depressive exacerbation in the early course of schizophrenia.
Previous studies have linked life events with depression in chronic schizophrenia, but those studies had methodological limitations. Using a prospective research design and examining events that were clearly independent of the patients' illnesses, the authors sought to determine whether stressful life events could trigger depressive symptoms in the early course of schizophrenia. Schizophrenia patients (n = 99) were followed for 1 year from a point of outpatient stabilization. Life event interviews were conducted every 4 weeks and symptom assessments every 2 weeks. Survival analyses showed a significantly increased risk for an exacerbation of significant depressive symptoms following an independent life event. Of interest is that an analysis of competing risk showed that the odds of psychotic exacerbation following a major independent life event were not significantly greater than the odds of depressive exacerbation. The risk of depression and of psychosis after experiencing a stressful life event is significantly increased for the first month, but the risk period can extend to 3 months.
Ventura
J
J
Department of Psychiatry, University of California, Los Angeles 90095-6968, USA. jventura@ucla.edu
Nuechterlein
K H
KH
Subotnik
K L
KL
Hardesty
J P
JP
Mintz
J
J
D000208:Acute Disease; D000328:Adult; D003863:Depression / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications*; D018570:Risk Assessment; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D013315:Stress, Psychological / Q000150:complications*; D016019:Survival Analysis