The typology and clinical features of depressions during a period of remission in paroxysmal schizophrenia

Abstract

Depressions in patients with schizophrenia in remission are quite common; however, their genesis and clinical features have been insufficiently studied.Objective: to assess the clinical features of depressions occurring in patients with paroxysmal schizophrenia in remission.Patients and methods. 88 patients with nonpsychotic depression who were diagnosed with paroxysmal schizophrenia in drug remission were examined. A total of 200 depressive episodes were analyzed. The patients' status was assessed according to the diagnostic criteria in the ICD-10 Classification of Depressive Disorders. For quantitative evaluation, the investigators used psychometric scales, such as the Calgary Depression Schizophrenia Scale and the PANSS Negative Subscale.Results. There were two types of post-schizophrenic depressions: endogenous and reactive. Endogenous depressions are divided into postpsychotic depressions developing in remission and delayed depressive episodes; reactive depressions are divided into nosogenic and psychogenic.Endogenous depressions represent a stage of the schizophrenic process; reactive ones are a schizophrenic patient's depressive reaction to a stressful situation. The latter occur in patients with a less severe schizophrenic defect, a higher critical attitude toward illness, and a better social and labor adaptation. Endogenous depressions have averagely a longer duration and a greater severity and besides anxiety symptoms, they include asthenic and apathetic symptoms; reactive depressions comprise only anxious and dreary manifestations.Conclusion. Knowledge about the characteristics of depressions in schizophrenia will ensure their more accurate diagnosis and prescribe adequate therapy.

Keywords

• paroxysmal schizophrenia
• remission
• postpsychotic depression
• endogenous depression
• reactive depression
• nosogenic depression
• clinical features