T27. DEPRESSIVE SYMPTOMS ARE ASSOCIATED WITH DURATION OF UNTREATED PSYCHOSIS (DUP) IN ANTIPSYCHOTIC NAIVE FIRST EPISODE PSYCHOSIS (FEP)

Abstract Background Depressive symptoms are common on first episode psychosis, with a prevalence of up to 83% of a full depressive episode. These symptoms are related to worst functionality and higher suicide rates. In literature, longer duration of untreated psychosis (DUP) and a worse premorbid ar...

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Veröffentlicht in:Schizophrenia bulletin 2019-04, Vol.45 (Supplement_2), p.S213-S213
Hauptverfasser: Nakamura, André, Cavalcante, Daniel, Coutinho, Luccas, Noto, Mariane, Oliveira, Giovany, Cordeiro, Quirino, Bressan, Rodrigo, Gadelha, Ary, Noto, Cristiano
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Sprache:eng
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Zusammenfassung:Abstract Background Depressive symptoms are common on first episode psychosis, with a prevalence of up to 83% of a full depressive episode. These symptoms are related to worst functionality and higher suicide rates. In literature, longer duration of untreated psychosis (DUP) and a worse premorbid are related to these symptoms. DUP is one of the most modifiable factors on FEP, with shorter DUP predicting better outcomes in patients with schizophrenia. Only a few studies explore the relation between depressive symptoms and DUP, with no studies in a Brazilian population. Therefore, our aim was to investigate the association between depressive symptoms, functionality and DUP of antipsychotic naive-FEP (AN-FEP) patients in a 10-week follow-up study. Methods We recruited 88 AN-FEP patients with first episode psychosis admitted to a psychiatric emergency service. We assessed diagnosis according to Structured Clinical Interview for DSM-IV (SCID-I). Depressive symptoms were measured with the depressive dimension of Positive and Negative Symptoms Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Clinical Global Impression Scale (CGI-S). We adopted the CDSS cut-off of 6, according to the Brazilian validation. All patients were treated with risperidone and revaluated after 10 weeks. For analysis, we performed non-parametric correlation tests (Spearman’s correlation). Results Prevalence of depressive syndrome according to CDSS was 20.4% at baseline, and 11.1% after treatment. Also, 4,6% of the patients started an antidepressant treatment. We found a mean DUP of 166 days (SD = 282, median = 47 days). We found a correlation between DUP and depressive dimension at baseline (r = -0.397; p < 0.001) and on follow-up (r = -0.322, p = 0.012). At both assessments, CDSS and the depressive scale of CGI-S scores did not show significant correlation with DUP. Discussion Prevalence of depression and median DUP was in line with the worldwide range. Surprisingly, this is the first study that shows a negative correlation between depressive symptoms and DUP, which is opposite to what most studies demonstrates and to what we expected. Depression is a common feature in FEP, yet their risk factors remain unclear. The relation between DUP and depressive symptoms should be more studied to understand the real influence of DUP in these patients.
ISSN:0586-7614
1745-1701
DOI:10.1093/schbul/sbz019.307