Psychiatria pre prax 3/2006

DEPRESSION IN SCHIZOPHRENIA

Concurrent depressive symptoms in schizophrenia are frequent; their incidence is estimated up to 65 %. Depression can occur in any phase of schizophrenia: first episode or chronic illness, during prodromal phase, acute episode, or as a postpsychotic depression. Some authors report a drug-induced depression after treatment with classical antipsychotics. Depression in schizophrenia is associated with increased risk of suicidal behavior. Diagnostics should differentiate comorbid depression from secondary depression, other schizophrenia symptoms, and other psychiatric conditions. Treatment of choice are second-generation antipsychotics (2GA). Their antidepressant efficacy has been sufficiently documented, some of them also showed anti-suicidal effects. Antidepressants may be used in treatment of more severe postpsychotic depression, if there is not sufficient treatment response to the 2GA.

Keywords: schizophrenia, depressive syndrome, suicide, second-generation antipsychotics.