title: Depressive symptom patterns in patients with chronic schizophrenia and subsyndromal depression.
abstract: BACKGROUND
  Since subsyndromal depressive symptoms (SDS) are prevalent, under-recognized and clinically important problems in patients with schizophrenia, as well as in the elderly, the association and correlates of SDS in mid-life and older age patients with schizophrenia deserves more investigation. The purpose of this study is to learn more about the occurrence, pattern of symptoms and associated features of subsyndromal depressive symptoms in patients with chronic schizophrenia or schizoaffective disorder.
  
  
  METHODS
  The first 165 participants from the "Citalopram Augmentation in Older Adults with Psychoses" (NIH RO1 # 63931) study comprised the sample. Inclusion criteria included: age > or =40, DSM-IV diagnosis of schizophrenia or schizoaffective disorder, outpatient status, >2 DSM-IV symptoms of MDE and Hamilton Depression Rating Scale (HAM-D) score > or =8. Depressive symptoms were assessed using the 17-item version of the HAM-D and the Calgary Depression Rating Scale (CDRS).
  
  
  RESULTS
  The most prevalent symptoms cut across several domains of the depressive syndrome: psychological (e.g., depressed mood, depressed appearance, psychic anxiety); cognitive (e.g., guilt, hopelessness, self depreciation, loss of insight); somatic (insomnia, anorexia, loss of libido, somatic anxiety); psychomotor (e.g., retardation and agitation) and functional (diminished work and activities). Participants diagnosed with schizoaffective disorder appeared more depressed, endorsed more intense "guilty ideas of reference" and had higher total CDRS scores than patients diagnosed with schizophrenia.
  
  
  CONCLUSIONS
  This study confirms the high prevalence of depressive symptoms in middle-aged and older persons with schizophrenia and schizoaffective disorder who were selected on the basis of having subsyndromal symptoms of depression.
authors.affiliation: Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA. szisook@ucsd.edu
authors.forename: Sidney
authors.initials: S
authors.lastname: Zisook
authors.forename: Maren
authors.initials: M
authors.lastname: Nyer
authors.forename: John
authors.initials: J
authors.lastname: Kasckow
authors.forename: Shah
authors.initials: S
authors.lastname: Golshan
authors.forename: David
authors.initials: D
authors.lastname: Lehman
authors.forename: Lori
authors.initials: L
authors.lastname: Montross
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003710:Demography; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000453:epidemiology* / Q000503:physiopathology*; D012720:Severity of Illness Index