Development and prediction of postpsychotic depression in neuroleptic-treated schizophrenics.

Data were collected during a year-long multicenter collaborative trial comparing short-acting fluphenazine hydrochloride with long-acting fluphenazine decanoate in a group of schizophrenic patients being maintained in the community. We examined the emergence and course of depressive symptomatology, operationally defined by the Hamilton Depression Scale total score. Of 211 patients, approximately 25% had depression develop within five months after discharge. Depressed patients had a more chronic psychiatric history and, contrary to the hypothesis that depression is a favorable prognostic indicator, they were more likely to relapse. There were no differences in incidence of emergent depression between the two drug treatment groups.

Facial electromyography in the assessment of improvement in depression.

Depressed patients who showed decreases in resting corrugator muscle tension levels, as measured electromyographically, also showed improvement in clinical symptoms, as assessed by the Hamilton Psychiatric Rating Scale over a 2-week period. Patients showing good clinical improvement after 2 weeks had resting pretreatment corrugator levels higher than those showing little clinical improvement, suggesting that corrugator activity might also serve as a forecaster of subsequent change. These findings support Darwin's 1872 hypothesis concerning the role of the "grief" muscle in depression. Furthermore, psychophysiological recording of patterns of facial muscle activity may have value in the clinical assessment of depression and treatment effects.