Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr;46(2):83-89.
doi: 10.1192/bjb.2021.15.

Recognition and management of depression in early psychosis

Zainab Bashir  1 , Sian Lowri Griffiths  2 , Rachel Upthegrove  2   3
Affiliations

Recognition and management of depression in early psychosis

Zainab Bashir et al. BJPsych Bull. 2022 Apr.

Abstract

Aims and method: Depression in first-episode psychosis (FEP) is highly prevalent and associated with poor outcomes; it has become increasingly recognised and adopted in national and international guidelines for psychosis. Using a 26-item questionnaire, this study aimed to explore if this shift has led to greater recognition among UK psychiatrists, and more effective management of depression in FEP.

Results: Of the 297 respondents, 54.4% observed depression occurring in chronic psychosis, with the least number of respondents (17.7%) identifying depression occurring frequently during FEP. Although there was reasonable agreement in the use of antidepressants as a first-line treatment for depression (70% prescribing antidepressants), there was uncertainty around assessing depression and delineating from psychosis symptoms, and particularly negative symptoms.

Clinical implications: Evidence-based treatments for comorbid depression in psychosis will lead to clearer national guidelines, allowing for optimal management of depression in early psychosis, potentially leading to improved outcomes for these individuals.

Keywords: Comorbidity; antidepressants; depressive disorders; early intervention; psychotic disorders.

PubMed Disclaimer

Conflict of interest statement

Supplementary material

Figures

Fig. 1
Fig. 1
Breakdown of main symptoms identified by respondents to diagnose depression in psychosis.
Fig. 2
Fig. 2
Proportions of antidepressants reported to be prescribed as first-line treatments for depression in early psychosis
Fig. 3
Fig. 3
Proportions of antipsychotics prescribed by respondents.
See this image and copyright information in PMC

References

    1. Birchwood M, Iqbal Z, Chadwick P, Trower P. Cognitive approach to depression and suicidal thinking in psychosis: I. Ontogeny of post-psychotic depression. Br J Psychiatry 2000; 177(6): 516–21. - PubMed
    1. Heiden W, Häfner H. The epidemiology of onset and course of schizophrenia. Eur Arch Psychiatry Clin Neurosci 2000; 250(6): 292–303. - PubMed
    1. Sands JR, Harrow M, Sands JR, Harrow M. Depression during the longitudinal course of schizophrenia. Schizophr Bull 1999; 25: 157–71. - PubMed
    1. Delahanty J, Ram R, Postrado L, Balis T, Green-Paden L, Dixon L. Differences in rates of depression in schizophrenia by race. Schizophr Bull 2001; 27: 29–38. - PubMed
    1. Crumlish N, Whitty P, Kamali M, Clarke M, Browne S, McTigue O, et al. Early insight predicts depression and attempted suicide after 4 years in first-episode schizophrenia and schizophreniform disorder. Acta Psychiatr Scand 2005; 112(6): 449–55. - PubMed

LinkOut - more resources