ABSTRACT
BACKGROUND: The present study evaluated differences in negative symptoms between schizophrenic and depressive patients and investigated whether a consideration of the nature of negative symptoms (enduring vs. nonenduring) can help to improve their specificity for schizophrenia. METHOD: Patients enrolled in the study were consecutively hospitalized with an acute exacerbation of schizophrenia (N = 33) or major depressive disorder (N = 43) (DSM-IV). Negative and depressive symptoms were assessed with the Scale for the Assessment of Negative Symptoms (SANS) and the Montgomery-Asberg Depression Rating Scale, respectively. Duration of negative symptoms was assessed through a semistructured interview with the patients and their closest relatives. On the basis of the assessed duration of symptoms, negative symptoms were categorized as enduring or nonenduring. RESULTS: Analyses revealed high SANS ratings for both diagnostic groups. Negative symptoms in depressive patients (p =.01), but not in schizophrenic patients, were significantly associated with the presence or the emergence of depressive symptoms. The prevalence of enduring negative symptoms was significantly higher in schizophrenic patients than in depressive patients (p <.01). A consideration of enduring negative symptoms significantly increased the discriminative power of negative symptoms for schizophrenia (p =.02). CONCLUSION: The present findings suggest that negative symptoms in most depressive patients are just an epiphenomenon of depressive symptoms and can be distinguished from schizophrenic negative symptoms.
Subject(s)
Depressive Disorder/diagnosis , Depressive Disorder/psychology , Schizophrenia/diagnosis , Schizophrenic Psychology , Acute Disease , Adult , Cross-Sectional Studies , Depressive Disorder/epidemiology , Diagnosis, Differential , Female , Hospitalization , Humans , Male , Prevalence , Psychiatric Status Rating Scales/statistics & numerical data , Severity of Illness IndexSubject(s)
Psychiatric Status Rating Scales , Schizophrenia/diagnosis , Adult , Female , Humans , Logistic Models , Male , Multivariate Analysis , Sensitivity and Specificity , Time FactorsABSTRACT
BACKGROUND: The aim of our study was to test the hypothesis that amygdala volumes are reduced in patients with recurrent major depression compared with first episode patients. METHODS: Using structural magnetic resonance imaging, we compared 30 inpatients with first-episode depression and 27 inpatients with recurrent major depression (DSM-IV) with healthy volunteer subjects from the local community matched for age, gender, and handedness. RESULTS: Patients with first-episode depression showed enlarged amygdala volumes compared with patients with recurrent major depression and healthy control subjects. No significant differences were found between patients with recurrent depression and healthy control subjects. No significant correlations were found between amygdala volumes and age of onset, illness duration, or severity of depression. CONCLUSIONS: Larger amygdala volumes in patients with first-episode depression may result from higher amygdala metabolism and blood flow. Additionally, disease progression with stress-related excitotoxic processes during recurrent depressive episodes might result in decreased amygdala volumes. Prospective investigations to investigate amygdala changes during the course of depression are needed.
Subject(s)
Amygdala/pathology , Depressive Disorder, Major/pathology , Depressive Disorder/pathology , Adult , Age of Onset , Aging/physiology , Depressive Disorder/psychology , Depressive Disorder, Major/psychology , Disease Progression , Female , Functional Laterality/physiology , Humans , Magnetic Resonance Imaging , Male , RecurrenceABSTRACT
OBJECTIVE: The aim of the study was to investigate the association between the duration of untreated psychosis, premorbid functioning and outcome from first inpatient treatment in schizophrenic or schizoaffective patients. METHOD: The data of 196 first-hospitalized patients with a schizophrenic or schizoaffective disorder according to the ICD-10 criteria were analyzed using univariate and multivariate methods. Patients' characteristics were prospectively assessed using standardized instruments at the time of first admission and discharge. RESULTS: The analyses revealed that a duration of untreated psychosis longer than 12 months was independently and significantly associated with a poorer outcome from first inpatient treatment. Premorbid functioning might have an additional influence on outcome, but this influence seems to be dependent on the diagnostic category. CONCLUSIONS: The findings suggest that the duration of untreated psychosis is an independent prognostic factor for the outcome in schizophrenic and schizoaffective disorders.
Subject(s)
Psychotic Disorders/psychology , Psychotic Disorders/rehabilitation , Schizophrenia/rehabilitation , Acute Disease , Adult , Female , Hospitalization , Humans , International Classification of Diseases , Logistic Models , Male , Prospective Studies , Psychotic Disorders/diagnosis , Schizophrenia/diagnosis , Schizophrenic Psychology , Time FactorsABSTRACT
OBJECTIVE: Previous work suggests that patients with unipolar depression may have structural as well as functional abnormalities in limbic-thalamic-cortical networks, which are hypothesized to modulate human mood states. A core area in these networks is the hippocampus. In the present study, differences in volumes of hippocampal gray and white matter between patients with a first episode of major depression and healthy comparison subjects were examined. METHOD: Thirty patients with a first episode of major depression and 30 healthy comparison subjects who were matched for age, gender, handedness, and education were examined with high-resolution magnetic resonance imaging. RESULTS: Male patients with a first episode of major depression had significantly smaller hippocampal total and gray matter volumes than healthy male comparison subjects. Both male and female patients showed significant alterations of left-right asymmetry and significant reductions of left and right hippocampal white matter fibers in relation to healthy comparison subjects. Hippocampal measurements were not significantly correlated with clinical variables, such as age at onset of illness, illness duration, or severity of depression. CONCLUSIONS: These results are consistent with findings of structural abnormalities of the hippocampal formation in patients with major depression that were more pronounced in male patients. The authors' findings support the hypothesis that the hippocampus and its connections within limbic-cortical networks may play a crucial role in the pathogenesis of major depression.
Subject(s)
Depressive Disorder/diagnosis , Hippocampus/anatomy & histology , Adult , Depressive Disorder/physiopathology , Female , Functional Laterality/physiology , Hippocampus/physiopathology , Humans , Magnetic Resonance Imaging , Male , Sex FactorsABSTRACT
BACKGROUND: The amygdala plays a crucial role in the mediation of affective behavior in humans and is implemented in the limbic-thalamic-cortical network that is supposed to modulate human mood. The aim of the present study was to measure the amygdala volumes in patients with a first episode of major depression. METHODS: Thirty inpatients with a first episode of depression were compared with 30 healthy volunteers matched for age, gender, handedness, and education by performing structural magnetic resonance imaging (MRI) measures of the amygdala. RESULTS: Patients showed increased amygdala volumes in both hemispheres as compared to healthy control subjects. No significant correlations were found between amygdala volumes and age, age of onset, illness duration, or severity of depression in the patient group. CONCLUSIONS: Enlarged amygdala volumes in patients with a first episode of major depression might be due to enhanced blood flow in the amygdala rather than to a neurodevelopmental structural predisposition to major depression.
