Depressive symptoms in acute schizophrenia

Area of Science:

• Psychiatry
• Clinical Psychology
• Psychopathology

Background:

• Psychopathological symptoms in depression and schizophrenia require accurate assessment tools.
• Existing rating scales may have limitations in sensitivity to treatment change and discriminating between patient groups.

Purpose of the Study:

• To compare the incidence of psychopathological symptoms in English and Swedish depressed patients.
• To develop and validate new, more sensitive rating scales for depression and schizophrenia.
• To assess the frequency of depressive symptoms in acute schizophrenia.

Main Methods:

• Comparison of symptom incidence using the Comprehensive Psychopathological Rating Scale (CPRS) in depressed patients.
• Development of the Montgomery and Asberg Depression Rating Scale (MADRS) based on treatment sensitivity.
• Derivation of a new schizophrenia rating scale from the CPRS based on treatment response discrimination.
• Comparative assessment of the new schizophrenia scale against the Brief Psychiatric Rating Scale (BPRS).

Main Results:

• The MADRS demonstrated greater sensitivity to treatment change compared to the Hamilton Rating Scale (HRS).
• A new 12-item schizophrenia scale showed superior discrimination between responders and non-responders than the BPRS.
• A high incidence of depressive symptoms was observed in patients with acute schizophrenia when assessed by the MADRS.

Conclusions:

• The MADRS is a more sensitive measure for depression than the HRS.
• The newly developed schizophrenia scale is a more effective discriminator of treatment response than the BPRS.
• Depressive symptoms appear to be a more common feature of acute schizophrenia than previously recognized.