Psychiatria pre prax 3/2024

Depression in schizophrenia: prevalence, diagnosis and consequences

Depression in schizophrenia is a relatively common problem, it can occur in up to 80 % of patients in the early stages of schizophrenia. There is a concept of post-schizophrenic depression, in the new revision of the classification of diseases it was replaced by qualifiers including depressive. Depression in schizophrenia is clinically different from depression in patients without the disorder – patients with schizophrenia reported sadness similar to those without schizophrenia, but slept longer and had lower levels of fatigue and pessimism. It is difficult to distinguish depression from negative symptoms – symptoms such as low mood, suicidal thoughts and pessimism are more typical for depression. A consequence of depression in patients with schizophrenia may be a higher risk of suicide. In addition to depression, there are other risk factors for suicidal behavior, but the only clear protective factor is antipsychotic treatment, especially clozapine and long-acting injectable antipsychotics of the second generation.

Keywords: depression, schizophrenia, depression in schizophrenia, post‑schizophrenic depression, suicidality