title: Rate and risk factors of depressive symptoms in Chinese patients presenting with first-episode non-affective psychosis in Hong Kong.
abstract: BACKGROUND
  Depressive symptoms are a distinct symptom dimension in psychotic disorders and are associated with elevated suicide risk, and poorer clinical and functional outcomes. Previous research on depressive symptoms mainly focused on chronic patients and few studies were conducted to investigate factors associated with depression in the early illness course. We aimed to examine the prevalence and risk factors of depressive symptoms, and their impacts on functioning, subjective quality of life (QoL) and self-efficacy in first-episode non-affective psychosis.
  
  
  METHODS
  Three hundred fifty-one Hong Kong Chinese aged 26-55years presenting with first-episode non-affective psychosis to early intervention service were recruited. Assessments encompassing sociodemographics, premorbid adjustment, clinical and treatment profiles, functioning, QoL and perceived self-efficacy were conducted. Patients who had Calgary Depression Scale for Schizophrenia (CDSS) total score ≥6 were classified as having depressive symptoms.
  
  
  RESULTS
  Fifty-three (15.1%) patients exhibited depressive symptoms at entry. Depressed patients had worse functioning, poorer QoL and lower level of self-efficacy than non-depressed counterparts. Multivariate regression analysis showed that previous exposure to stressful life events, unemployment, being married, more severe positive symptoms, higher level of antipsychotic-induced Parkinsonism and negative attitude towards medication treatment were independently associated with depression status.
  
  
  CONCLUSIONS
  Depressive symptoms were frequently observed in adult patients with first-episode nonaffective psychosis, and were linked to poor functioning and QoL. Our findings indicated that, aside from social and clinical risk factors, presence of drug-induced Parkinsonism and negative treatment attitude may render patients more vulnerable to developing depression in the early stage of psychotic illness.
authors.affiliation: Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong. Electronic address: changwc@hku.hk.
authors.forename: Wing Chung
authors.initials: WC
authors.lastname: Chang
authors.affiliation: Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
authors.forename: Rowan
authors.initials: R
authors.lastname: Cheung
authors.affiliation: Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
authors.forename: Christy Lai Ming
authors.initials: CL
authors.lastname: Hui
authors.affiliation: Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
authors.forename: Jingxia
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong.
authors.forename: Sherry Kit Wa
authors.initials: SK
authors.lastname: Chan
authors.affiliation: Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
authors.forename: Edwin Ho Ming
authors.initials: EH
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong.
authors.forename: Eric Yu Hai
authors.initials: EY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020734:Parkinsonian Disorders / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D020377:Self Efficacy
keywords: Depressive symptoms; First-episode psychosis; Negative treatment attitude; Prevalence; Risk factors