Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-19T12:29:02.127Z Has data issue: false hasContentIssue false
  • English
  • Français

The course of depressive symptoms and prescribing patterns of antidepressants in schizophrenia in a one-year follow-up study

Published online by Cambridge University Press:  15 April 2020

I.M. Lako ,
K. Taxis ,
R. Bruggeman ,
H. Knegtering ,
H. Burger ,
D. Wiersma  and
C.J. Slooff
I.M. Lako
Affiliation:
Rob Giel Research Center (RGOc), Department of Psychiatry (UCP), University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands Division of Pharmacotherapy and Pharmaceutical Care, Department of Pharmacy, University of Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands
K. Taxis*
Affiliation:
Division of Pharmacotherapy and Pharmaceutical Care, Department of Pharmacy, University of Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands
R. Bruggeman
Affiliation:
Rob Giel Research Center (RGOc), Department of Psychiatry (UCP), University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands Division of Pharmacotherapy and Pharmaceutical Care, Department of Pharmacy, University of Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands
H. Knegtering
Affiliation:
Rob Giel Research Center (RGOc), Department of Psychiatry (UCP), University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands Lentis Center for Mental Health Care and UMCG Neuroimaging Center, University of Groningen, Hereweg 80, 9725 AG, Groningen, The Netherlands
H. Burger
Affiliation:
Rob Giel Research Center (RGOc), Department of Psychiatry (UCP), University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands Department of Epidemiology, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
D. Wiersma
Affiliation:
Rob Giel Research Center (RGOc), Department of Psychiatry (UCP), University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
C.J. Slooff
Affiliation:
Rob Giel Research Center (RGOc), Department of Psychiatry (UCP), University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands Department of Psychotic Disorders, Mental Health Centre Assen (GGZ Drenthe), Dennenweg 9, 9404 LA, Assen, The Netherlands
*
*Corresponding author. Tel.: +31 50 3638205; fax: +31 50 3632772. E-mail address: k.taxis@rug.nl (K. Taxis).
Get access

Abstract

Background

Antidepressants are frequently prescribed in patients with psychotic disorders, but little is known about their effects in routine clinical practice. The objective was to investigate the prescribing patterns of antidepressants in relation to the course of depressive symptoms in patients with psychotic disorders.

Methods

A cohort of 214 Dutch patients with psychotic disorders received two assessments of somatic and psychiatric health, including a clinician-rated screening for depressive symptoms, as part of annual routine outcome monitoring.

Results

Depressive symptoms were prevalent among 43% (93) of the patients. Antidepressants were prescribed for 40% (86) of the patients and the majority 83% (71) continued this therapy after one year. Multivariable analysis showed that patients with more severe psychopathology had a higher risk to develop depressive symptoms the following year (OR [95% CI]=0.953 [0.912–0.995]). For patients with depressive symptoms at baseline, polypharmacy was a potential risk factor to keep having depressive symptoms (OR [95% CI]=1.593 [1.123–2.261]). Antidepressant use was not an independent predictor in both analyses.

Conclusions

Routine outcome monitoring in patients with psychotic disorders revealed a high prevalence of depressive symptoms. Antidepressants were frequently prescribed and continued in routine clinical practice.

Keywords

SchizophreniaPsychosisPsychopharmacologyAntidepressantPrescribing patternsClinical practice
Type
Original article
Information
European Psychiatry , Volume 27 , Issue 4 , May 2012 , pp. 240 - 244
Copyright
Copyright © Elsevier Masson SAS 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addington, D., Addington, J., Atkinson, M.A psychometric comparison of the Calgary Depression Scale for Schizophrenia and the Hamilton Depression Rating Scale. Schizophr Res. 1996; 19: 205–212.CrossRefGoogle ScholarPubMed
Addington, D., Addington, J., Patten, S., Remington, G., Moamai, J., Labelle, A.et al.Double-blind, placebo-controlled comparison of the efficacy of sertraline as treatment for a major depressive episode in patients with remitted schizophrenia. J Clin Psychopharmacol. 22 1: 2002 20–25.CrossRefGoogle Scholar
American Psychiatric Association Practice guideline for the treatment of patients with schizophrenia. 2nd ed 2004 Arlington United States of America.Google Scholar
An Der Heiden, W., Konnecke, R., Maurer, K., Ropeter, D., Hafner, H.Depression in the long-term course of schizophrenia. Eur Arch Psychiatry Clin Neurosci. 2005; 255: 174–184.CrossRefGoogle ScholarPubMed
An, F.R., Xiang, Y.T., Wang, C.Y., Zhang, G.P., Chiu, H.F., Chan, S.S.et al.Change of psychotropic drug prescription for schizophrenia in a psychiatric institution in Beijing, China between 1999 and 2008. Int J Clin Pharmacol Ther Toxicol. 2010; 48: 270–274.CrossRefGoogle Scholar
Angermeyer, M.C., Kuhn, L., Goldstein, J.M.Gender and the course of schizophrenia: differences in treated outcomes. Schizophr Bull. 1990; 16: 293–307.CrossRefGoogle ScholarPubMed
Bartels, S.J., Drake, R.E.Depressive symptoms in schizophrenia: comprehensive differential diagnosis. Compr Psychiatry. 1988; 29: 467–483.CrossRefGoogle ScholarPubMed
Baynes, D., Mulholland, C., Cooper, S.J., Montgomery, R.C., MacFlynn, G., Lynch, G.et al.Depressive symptoms in stable chronic schizophrenia: prevalence and relationship to psychopathology and treatment. Schizophr Res. 2000; 45: 47–56.CrossRefGoogle ScholarPubMed
Birchwood, M., Mason, R., MacMillan, F., Healy, J.Depression, demoralization and control over psychotic illness: a comparison of depressed and non-depressed patients with a chronic psychosis. Psychol Med. 23 2: 1993 387–395.CrossRefGoogle ScholarPubMed
Buckley, P.F., Miller, B.J., Lehrer, D.S., Castle, D.J.Psychiatric comorbidities and schizophrenia. Schizophr Bull. 35 2: 2008 383–402.CrossRefGoogle Scholar
Carpenter, W.T., Strauss, J.S.The prediction of outcome in schizophrenia. IV: eleven-year follow-up of the Washington IPSS cohort. J Nerv Ment Dis. 1991; 179: 517–525.CrossRefGoogle ScholarPubMed
Conley, R.R., Ascher-Svanum, H., Zhu, B., Faries, D.E., Kinon, B.J.The burden of depressive symptoms in the long-term treatment of patients with schizophrenia. Schizophr Res. 2007; 90: 186–197.CrossRefGoogle ScholarPubMed
DSM-IV - Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Washington, DC, United States of America: American Psychiatric Association; 1994.Google Scholar
Duisterwinkel, G., Bosker, F.J., Scholte-Stalenhoef, A.N., Vervoort, M., Knegtering, H.Antipsychotic augmentation strategies to ameliorate negative and cognitive symptoms in schizophrenia; implications for future research. Cent Nerv Syst Agents Med Chem. 2008; 8: 10–25.CrossRefGoogle Scholar
Freudenreich, O., Tranulis, C., Cather, C., Henderson, D.C., Evins, A.E., Goff, D.C.Depressive symptoms in schizophrenia outpatients - Prevalence and clinical correlates. Clin Schizophr Relat Psychoses. 2 2: 2008 127–135.CrossRefGoogle Scholar
Geddes, J.R., Carney, S.M., Davies, C., Furukawa, T.A., Kupfer, D.J., Frank, E.et al.Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet. 2003; 361: 653–661.CrossRefGoogle ScholarPubMed
Häfner, H.Gender differences in schizophrenia. Psychoneuroendocrinology. 28 2: 2003 17–54.CrossRefGoogle Scholar
Harrow, M., Yonan, C.A., Sands, J.R., Marengo, J.Depression in schizophrenia: are neuroleptics, akinesia, or anhedonia involved?. Schizophr Bull. 1994; 20: 327–338.CrossRefGoogle ScholarPubMed
Hirsch, S.R., Jolley, A.G., Barnes, T.R., Liddle, P.F., Curson, D.A., Patel, A.et al.Dysphoric and depressive symptoms in chronic schizophrenia. Schizophr Res. 1989; 2: 259–264.CrossRefGoogle ScholarPubMed
Johnson, D.A.Studies of depressive symptoms in schizophrenia. Br J Psychiatry. 1981; 139: 89–101.CrossRefGoogle Scholar
Kaymaz, N., Van Os, J., Loonen, A.J., Nolen, W.A.Evidence that patients with single versus recurrent depressive episodes are differentially sensitive to treatment discontinuation: a meta-analysis of placebo-controlled randomized trials. J Clin Psychiatry. 2008; 69: 1423–1436.CrossRefGoogle ScholarPubMed
Kirsch, I., Deacon, B.J., Huedo-Medina, T.B., Scoboria, A., Moore, T.J., Johnson, B.T.Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med. 5 2: 2008 260–268.CrossRefGoogle ScholarPubMed
Koreen, A.R., Siris, S.G., Chakos, M., Alvir, J., Mayerhoff, D., Lieberman, J.Depression in first-episode schizophrenia. Am J Psychiatry. 1993; 150: 1643–1648.Google ScholarPubMed
Kulhara, P., Avasthi, A., Chadda, R., Chandiramani, K., Mattoo, S.K., Kota, S.K.et al.Negative and depressive symptoms in schizophrenia. Br J Psychiatry. 1989; 154: 207–211.CrossRefGoogle Scholar
Lam, R.W., Peters, R., Sladen-Dew, N., Altman, S.A community-based clinic survey of antidepressant use in persons with schizophrenia. Can J Psychiatry. 1998; 43: 513–516.CrossRefGoogle ScholarPubMed
Leff, J., Tress, K., Edwards, B.The clinical course of depressive symptoms in schizophrenia. Schizophr Res. 1988; 1: 25–30.CrossRefGoogle Scholar
Lindenmayer, J.P., Kay, S.R.Depression, affect and negative symptoms in schizophrenia. Br J Psychiatry. 11 7: 1989 108–114.CrossRefGoogle Scholar
Micallef, J., Fakra, E., Blin, O.Use of antidepressant drugs in schizophrenic patients with depression. Encephale. 2006; 32: 263–269.CrossRefGoogle ScholarPubMed
Mickey, J., Greenland, S.A study of the impact of confounder-selection criteria on effect estimation. Am J Epidemiol. 1989; 128: 125–137.CrossRefGoogle Scholar
Möller, H.J.Drug treatment of depressive symptoms in schizophrenia. Clin Schizophr Relat Psychoses. 1 4: 2008 328–340.CrossRefGoogle Scholar
Müller, M.J.Gender-specific associations of depression with positive and negative symptoms in acute schizophrenia. Prog Neurpsychopharmacol Biol Psychiatry. 2007; 31: 1095–1100.CrossRefGoogle ScholarPubMed
National Institute for Clinical Excellence (NICE). National clinical practice guideline for schizophrenia. United Kingdom; 2008.Google Scholar
Plasky, P.Antidepressants usage in schizophrenia. Schizophr Bull. 17 4: 1991 649–657.CrossRefGoogle Scholar
Restifo, K., Harkavy-Friedman, J.M., Shrout, P.E.Suicidal behavior in schizophrenia: a test of the demoralization hypothesis. J Nerv Ment Dis. 2009; 197: 147–153.CrossRefGoogle ScholarPubMed
Ritsner, M., Kurs, R., Gibel, A., Hirschmann, S., Shinkarenko, E., Ratner, Y.Predictors of quality of life in major psychoses: a naturalistic follow-up study. J Clin Psychiatry. 2003; 64: 308–315.CrossRefGoogle ScholarPubMed
Rittmannsberger, H., Meise, U., Schauflinger, K., Horvath, E., Donat, H., Hinterhuber, H.Polypharmacy in psychiatric treatment. Patterns of psychotropic drug use in Austrian psychiatric clinics. Eur Psychiatry. 1999; 14: 33–40.CrossRefGoogle ScholarPubMed
Rocca, P., Bellino, S., Calvarese, P., Marchiaro, L., Patria, L., Rasetti, R.et al.Depressive and negative symptoms in schizophrenia: different effects on clinical features. Compr Psychiatry. 46 4: 2005 304–310.CrossRefGoogle ScholarPubMed
Rummel, C., KisslingW, Leucht, S.Antidepressants for the negative symptoms of schizophrenia. Cochrane Database Syst Rev. 2006; 3: CD005581.Google Scholar
Sands, J.R., Harrow, M.Depression during the longitudinal course of schizophrenia. Schizophr Bull. 1999; 25: 157–171.CrossRefGoogle ScholarPubMed
Schorr, S.G., Slooff, C.J., Bruggeman, R., Taxis, K.Prevalence of metabolic syndrome in patients with psychotic disorders in the Netherlands. J Clin Psychopharmacol. 29 4: 2009 399–402.CrossRefGoogle ScholarPubMed
Schorr, S.G., Slooff, C.J., Bruggeman, R., Taxis, K.The incidence of metabolic syndrome and its reversal in a cohort of schizophrenic patients followed for one year. J Psychiatric Res. 43 13: 2009 1106–1111.CrossRefGoogle Scholar
Sepehry, A.A., Potvin, S., Elie, R., Stip, E.Selective serotonin reuptake inhibitor (SSRI) add-on therapy for the negative symptoms of schizophrenia: a meta-analysis. J Clin Psychiatry. 2007; 68: 604–610.CrossRefGoogle ScholarPubMed
Siris, S.G., Adan, F., Cohen, M., Mandeli, J., Aronson, A., Casey, E.Postpsychotic depression and negative symptoms: an investigation of syndromal overlap. Am J Psychiatry. 12 145: 1988 1532–1537.Google Scholar
Siris, S.G., Bench, C.Depression and schizophrenia. Hirsch, S.Weinberger, D. Schizophrenia. 2nd ed 2003 Blackwell Oxford, UK140–167.Google Scholar
Trimbos-Institute. Multidisciplinary Guideline on Schizophrenia. Utrecht, The Netherlands; 2010.Google Scholar
Van Putten, T., May, R.P.“Akinetic depression” in schizophrenia. Arch Gen Psychiatry. 1978; 35: 1101–1107.CrossRefGoogle Scholar
Whitehead, C., Moss, S., Cardno, A., Lewis, G.Antidepressants for people with both schizophrenia and depression. Cochrane Database Syst Rev. 2 CD002305 2002 1469–1493.Google Scholar
Submit a response

Comments

No Comments have been published for this article.