Depressive symptomatology in the first-episode schizophrenia spectrum disorders OPTiMiSE trial: prevalence, correlates, symptom progression and outcomes

TL;DR

This study examines how common and impactful depressive symptoms are in people with early schizophrenia, finding that depression is linked to worse outcomes.

Contribution

The study provides new insights into the prevalence and consequences of depression in first-episode schizophrenia spectrum disorders.

Findings

Depressive symptoms were prevalent at baseline in 27.5% of participants with first-episode schizophrenia.

Baseline depression was associated with worse psychosocial functioning and subjective wellbeing at week 4.

Depressive symptom improvement correlated with reduced psychosis severity over 10 weeks.

Abstract

Numerous aspects of depressive symptomatology in first-episode schizophrenia spectrum disorders (FES) remain unclear. Based on data from the FES OPTiMiSE trial, we estimated the prevalence of depression (Calgary Depression Scale for Schizophrenia (CDSS) total score ≥7) at baseline (n = 122, 27.5%) and at weeks 4 (n = 57, 15.9%) and 10 (n = 14, 21.5%). Baseline depression was cross-sectionally associated with more severe extrapyramidal symptoms (p = 0.036) and poorer subjective wellbeing (p < 0.001). At week 4, baseline depression was linked to poorer psychosocial functioning (p < 0.001) and subjective wellbeing (p < 0.001). At week 10, baseline depression was associated with psychosis non-remission (p = 0.042) and worse subjective wellbeing (p = 0.011). There was a significant correlation between decrease in CDSS and PANSS total scores (p < 0.001) at weeks 4 and 10. Depressive symptomatology in the FES OPTiMiSE trial was prevalent and associated with poorer objectively- and subjectively-measured outcomes over a 10-week follow-up. Early intervention for depression may improve outcomes in FES.