Depressive Symptoms in Medicated Patients with Schizophrenia: An Egyptian Sample
Authors: Mohamed Ali Asmaa Ahmed , Omar Abdel Nasser Mahmoud , Hatata Hisham Ahmed , Moneim Mahmoud Dalia Abdel , Mohamed Mohamed Youssef 
Published: November 2024

Abstract

Background
Schizophrenia is a psychotic disorder. Persons with schizophrenia may experience hallucinations, delusions, disorganized behaviors, negative symptoms and disturbance in social functioning. Schizophrenia consists of a range of features. Patients may display improper affect and delusions and as a result, fear and worry may follow. The incidence of depressive episodes is common in schizophrenia, with a common symptomatology. Consequently, the diagnosis of their comorbidity is challenging for both clinicians and researchers. Within this context, the presence of comorbid depression negatively affects quality of life, underlies psycho pathology and the brutality of associated medical conditions 10. In addition, pharmacotherapy of schizophrenic patients with depression is different from that of patients with schizophrenia alone.

Objective
This study aims to To measure the intensity of suicidal ideations in the patients diagnosed with schizophrenia and co-morbid depression and to compare the severity of depression and suicidal symptoms in patients diagnosed with schizophrenia and co-morbid depression who are compliant on treatment regarding taking with conventional or atypical antipsychotics.

Patients and Methods
Between November 2022 and March 2023 in Ain Shams University, 92 patients attending the General Psychiatry outpatient clinics at Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University Hospitals (all aged 18–65 years) were interviewed using semi-structured designed questionnaire to assess psychiatric, medical history, medication history, SCID I for diagnosis of schizophrenia and depression according to the DSM-IV, The Hamilton Depression Rating Scale (HAM-D) for assessing the presence and severity of depressive symptoms, Beck’s suicidal ideation scale (BSI) for detecting and measuring the current intensity of the patients’ specific attitudes, behaviors, plans to commit suicide, Morisky 8-Item Medication Adherence Scale (MMAS) and Socioeconomic status scale (SES).

Results
On descriptive analysis between children and adolescents presenting with psychiatric and neurologic complaints The Hamilton depression scale showed significant difference as, median Hamilton depression scale in patients who consumed typical medication 8 with IQR = 5.75 was higher than median Hamilton depression scale in patients who consumed atypical medication 5 with IQR = 3, p-value = 0.002. Meanwhile, Number of previous hospitalizations showed significant association as, median previous hospitalizations in patients who consumed atypical medication 2 with IQR = 2 was higher than median previous hospitalizations in patients who consumed typical medication 1 with IQR = 1, p-value = 0.026.

Conclusion
In conclusion, the present study suggests that patients with schizophrenia who have not been diagnosed with depression frequently have clinical symptoms of depression, with the possible exception of a contribution from negative symptoms. However, depressive symptoms may be more common in schizophrenic patients treated with typical antipsychotic drugs than in schizophrenic patients treated with atypical.