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Depressive disorders

What are depressive disorders?

Depression is characterised by a depressed mood and/or a loss of interest or pleasure in activities. Symptoms of depression include changes in appetite, weight, sleep, and psychomotor activity, decreased energy, blunted affect, social withdrawal, difficulty concentrating or making decisions, feelings of worthlessness, hopelessness and guilt, and thoughts of suicide. As many symptoms are common to both depression and the negative syndrome of schizophrenia it can be difficult to identify a comorbid depressive illness in people with schizophrenia. Identifying and treating a comorbid depressive illness may increase the likelihood of recovery from psychosis and reduce the likelihood of psychotic relapse.

What is the evidence for comorbid depression?

Moderate to high quality evidence found the prevalence of a diagnosed depressive disorder in people with first-episode schizophrenia was around 26%. The prevalence was higher when using depression symptom scores (around 45%). The prevalence of depressive disorders in people at high risk for psychosis who were showing subclinical symptoms was around 41%.

Moderate to high quality evidence finds a medium to large improvement in global state with adjunctive antidepressants in people with schizophrenia compared to adjunctive placebo, with no additional benefit for reducing specific symptoms. Moderate to low quality evidence suggests patients receiving the antipsychotic sulpride may show greater improvement in depressive symptoms than patients receiving the antipsychotic chlorpromazine. Patients receiving the antipsychotic clozapine may show greater improvement in depressive symptoms than patients receiving any other antipsychotic combined with the antidepressants amitryptiline, mianserin, meclobemide or with placebo. No differences in improvement were found between people taking the antipsychotics quetiapine or haloperidol.

June 2020

Last updated at: 5:06 am, 17th June 2020
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Title Colour Legend:
Green - Topic summary is available.
Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.