The evolution of depression in first-episode psychosis: A naturalistic database study

Depression is commonly seen in the course of schizophrenia and can occur during any of the phases of the psychotic illness. The present study examines the incidence of depression at baseline and de novo depression in first episode of nonaffective psychoses and the course of depression in the 12 months following first-episode psychosis, any predictive significance of baseline depression with recurrence of depression in the subsequent phases of the psychotic illness. The study was conducted with a clinical sample of 460 patients under the care of a first-episode psychosis programme, and data relating to duration of untreated psychosis, sociodemographic data, Positive and Negative Symptom Scale (PANSS), Global Assessment of Functioning (GAF), and Clinical Global Impression (CGI) were collected. Diagnosis was made by at least two psychiatrists using SCID-1, and depression was measured by Patient Health Questionnaire (PHQ-9). Statistical analysis was performed using SAS version 9. We performed multiple logistic regression analyses to identify the sociodemographic and clinical factors that were associated with depression. Statistical significance was set at p value less than 0.05. We found that baseline depression was present in 34.42% patients with a preponderance of females (p = 0.047) and in those with secondary education. A suicide attempt is a strong predictor for depression at baseline. There was lower incidence of depression in those diagnosed with brief psychotic disorder (p = 0.015) and those with lower PANSS positive scores (p = 0.017). De novo depression over 12 months was 9.44%. Depression at 1-year follow-up was significantly predicted by depression at baseline.