A discriminant validity study of negative symptoms with a special focus on depression and antipsychotic medication

Article Abstract:

Previous studies of schizophrenia have associated negative symptoms with biological causes. Negative symptoms in schizophrenia involve a lack of the ability to function normally. A problem associated with the negative symptoms of schizophrenia is the overlap with other disorders, which can make diagnosis difficult. Similarities to depression and the effects of antipsychotic drug therapy may be seen. This study examined negative symptoms with particular attention paid to depression and the effects of antipsychotic medication in 26 schizophrenic patients and in 21 patients without schizophrenia, but with other mental disorders; most of the non-schizophrenic patients were depressed. Demographic and clinical characteristics of all patients were evaluated, and the subjects were scored using the Scale for the Assessment of Negative Symptoms, the Hamilton depression scale, and the Simpson-Angus Scale. Data on patients were collected after a two-week 'washout period' in which no medications were administered, and again after a two-month drug treatment period. The schizophrenic patients were clearly distinguished from those without schizophrenia. The non-schizophrenic patients scored higher on the Hamilton depression scale and the schizophrenics scored higher on the Scale for the Assessment of Negative symptoms. The patients without schizophrenia showed a greater response to drug treatment than the schizophrenic group; medication had less effect on the symptoms of the schizophrenics. It was concluded that the negative symptoms in the schizophrenics could be differentiated from symptoms of depression. This also supports the use of the Scale for the Assessment of Negative Symptoms for evaluating the negative symptom syndrome associated with schizophrenia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Physiological aspects, Schizophrenia, Antipsychotic drugs, Antipsychotic agents

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Familial alcoholism in primary unipolar major depressive disorder

Article Abstract:

Results of studies examining relationships between depression and familial alcoholism have been inconsistent. However, many studies do demonstrate that females diagnosed with depressive disorder who come from alcoholic families tend to have more marital and sexual problems and more generally unstable lifestyles than other depressed patients. To further explore the relationships between major depression and familial alcoholism, 723 primary relatives of 326 nonalcoholic patients diagnosed with major depression were interviewed, and their diagnoses were compared with those of 469 relatives of nondepressed comparison subjects who served as a control group. Subjective personal information relayed by the depressed patients and controls, as well as information gathered from relatives, was assessed. Analysis of the data revealed significantly more alcoholism in families of depressed women than in families of control subjects. Families of depressed men did not demonstrate any more alcoholism than those of control subjects. It is not yet known whether associations between familial alcoholism and depression in women are genetic in nature. It is considered likely that interactive effects of genetic and environmental factors, such as difficulties inherent in living with an alcoholic, contribute to this association. (Consumer Summary produced by Reliance Medical Information, Inc.)

Genetic aspects

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Comparison of adolescent- and adult-onset unipolar depression

Article Abstract:

Unipolar depression (as distinct from bipolar depression, more commonly known as manic depression) may be a risk for relatives of depressed patients depending upon three factors: early age at onset, concurrent anxiety disorder and alcoholism. Previous research suggests that when depression begins before age 20, there is a high probability of depression in a close relative, whereas when depression begins after 40, the probability is about the same as for normal subjects. To confirm the validity of using age at onset of depression as a way of classifying types of depression, 20 depressed patients with adolescent onset were compared with 38 adult onset depressives. The two groups were similar by family history. Prior to onset, the adult-onset group was consistently superior to the adolescent-onset group in social, sexual, and occupational function. In terms of psychopathology, the major difference between the two groups was the prevalence of alcohol abuse among the adult-onset patients. On the basis of the results, the authors suggest that age at onset and concomitant prevalence of substance abuse may define clinically distinct subtypes of unipolar depression.

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