Format

Send to

Choose Destination
Br J Psychiatry. 2018 Aug;213(2):464-470. doi: 10.1192/bjp.2018.87. Epub 2018 Jun 6.

Remission of depression in patients with schizophrenia and comorbid major depressive disorder: results from the FACE-SZ cohort.

Author information

1
Fondation FondaMental,Créteil,France and Faculté de Médecine,Aix-Marseille Université, Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie,France.
2
Fondation FondaMental,Créteil,France and INSERM U1114,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg,France.
3
Fondation FondaMental,Créteil, France and UMR_S 1136, INSERM,Institut Pierre Louis d'Epidémiologie et de Santé Publique, l'université Pierre et Marie Curie, Sorbonne Universités,France.
4
Fondation FondaMental,Créteil,France and INSERM U955,Université Paris-Est Créteil, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor,France.
5
Fondation FondaMental,Créteil,France,Centre Hospitalier Charles Perrens,Université de Bordeaux, France and INRA, NutriNeuro, University of Bordeaux,France.
6
Fondation FondaMental,Créteil, France and INSERM 1061,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1,France.
7
Fondation FondaMental, Créteil,France and CMP B, CHU,EA 7280 Faculté de Médecine,Université d'Auvergne,France.
8
Fondation FondaMental,Créteil, France and INSERM U1028,CNRS UMR5292,Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier,France.
9
Fondation FondaMental, Créteil,France,AP-HP, Department of Psychiatry,Louis Mourier Hospital, Colombes, France and INSERM U894, Faculté de médecine,Université Paris Diderot,Sorbonne Paris Cité,France.
10
Fondation FondaMental, Créteil,France and Centre Référent de Réhabilitation Psychosociale,CH Alpes Isère,France.
11
Fondation FondaMental, Créteil,France,AP-HP, Department of Psychiatry,Louis Mourier Hospital,Colombes,France and INSERM U894,Faculté de médecine,Université Paris Diderot,Sorbonne Paris Cité,France.
12
Fondation FondaMental,Créteil, France,Centre Hospitalier Charles Perrens, Université de Bordeaux, France and CNRS UMR 5287,Institut de Neurosciences cognitives et intégratives d'Aquitaine, Université de Bordeaux,France.
13
Fondation FondaMental,Créteil,France and Centre Hospitalier de Versailles,Service de psychiatrie et d'addictologie adulte,Le Chesnay,EA 4047 HANDIReSP,UFR des Sciences de la Santé Simone Veil,Université Versailles Saint-Quentin-en-Yvelines,France.
14
Fondation FondaMental,Créteil,France and INSERM U1028,CNRS UMR5292,Centre de Recherche en Neurosciences de Lyon,Université Claude Bernard Lyon 1, Equipe PSYR2,Centre Hospitalier Le Vinatier,France.
15
Fondation FondaMental,Créteil,France and INSERM 1061,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1,France.
16
INSERM U1114,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg,Fédération de Médecine Translationnelle de Strasbourg,France.
17
Fondation FondaMental,Créteil,France and CMP B, CHU,EA 7280 Faculté de Médecine,Université d'Auvergne,France.

Abstract

BACKGROUND:

Major depressive disorder (MDD) is underdiagnosed and undertreated in schizophrenia, and has been strongly associated with impaired quality of life.AimsTo determine the prevalence and associated factors of MDD and unremitted MDD in schizophrenia, to compare treated and non-treated MDD.

METHOD:

Participants were included in the FondaMental Expert Centers for Schizophrenia and received a thorough clinical assessment. MDD was defined by a Calgary score ≥6. Non-remitted MDD was defined by current antidepressant treatment (unchanged for >8 weeks) and current Calgary score ≥6.

RESULTS:

613 patients were included and 175 (28.5%) were identified with current MDD. MDD has been significantly associated with respectively paranoid delusion (odds ratio 1.8; P = 0.01), avolition (odds ratio 1.8; P = 0.02), blunted affect (odds ratio 1.7; P = 0.04) and benzodiazepine consumption (odds ratio 1.8; P = 0.02). Antidepressants were associated with lower depressive symptoms score (5.4 v. 9.5; P < 0.0001); however, 44.1% of treated patients remained in non-remittance MDD. Nonremitters were found to have more paranoid delusion (odds ratio 2.3; P = 0.009) and more current alcohol misuse disorder (odds ratio 4.8; P = 0.04). No antidepressant class or specific antipsychotic were associated with higher or lower response to antidepressant treatment. MDD was associated with Metabolic syndrome (31.4 v. 20.2%; P = 0.006) but not with increased C-reactive protein.

CONCLUSIONS:

Antidepressant administration is associated with lower depressive symptom level in patients with schizophrenia and MDD. Paranoid delusions and alcohol misuse disorder should be specifically explored and treated in cases of non-remission under treatment. MetS may play a role in MDD onset and/or maintenance in patients with schizophrenia.Declaration of interestNone.

PMID:
29871707
DOI:
10.1192/bjp.2018.87
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Cambridge University Press
Loading ...
Support Center