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 suggests the prevalence of depressive disorders in people at high risk for psychosis is around 41%. No reviews were identified that assessed the prevalence of depression in people with schizophrenia.

Moderate to high quality evidence finds a medium to large improvement in global state with adjunctive antidepressants (plus antipsychotics) compared to adjunctive placebo (plus antipsychotics), 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 depressive symptoms were found between people taking the antipsychotics quetiapine or haloperidol.

April 2019

Last updated at: 3:19 am, 23rd April 2019
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