Cognitive approach to depression and suicidal thinking in psychosis. 1. Ontogeny of post-psychotic depression.
BACKGROUND
Depression in schizophrenia is a rather neglected field of study, perhaps because of its confused nosological status. Three course patterns of depression in schizophrenia, including post-psychotic depression (PPD), are proposed.


OBJECTIVE
We chart the ontogeny of depression and psychotic symptoms from the acute psychotic episode over a 12-month period and test the validity of the proposed course patterns.


METHODS
One hundred and five patients with ICD-10 schizophrenia were followed up on five occasions over 12 months following the acute episode, taking measures of depression, positive symptoms, negative symptoms, neuroleptic exposure and side-effects.


RESULTS
Depression accompanied acute psychosis in 70% of cases and remitted in line with the psychosis; 36% developed PPD without a concomitant increase in psychotic symptoms.


CONCLUSIONS
The results provided support for the validity of two of the three course patterns of depression in schizophrenia, including PPD. Post-psychotic depression occurs de novo without concomitant change in positive or negative symptoms.
Birchwood
M
M
Northern Birmingham Mental Health NHS Trust and University of Birmingham, Birmingham, UK.
Iqbal
Z
Z
Chadwick
P
P
Trower
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology*; D018450:Disease Progression; D006801:Humans; D008875:Middle Aged; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology*; D012565:Schizophrenic Psychology; D013405:Suicide / Q000523:psychology; D013850:Thinking; D000092864:Suicide Prevention