July 01, 2007

Treatment of the Non-Psychotic Dimensions of Schizophrenia is a Critical Part of Recovery

The Schizophrenia Research journal published a study earlier this year on the presence of non-psychotic symptoms, specifically depression, and the limitations they may create in treatment outcomes. The study focused on the link between depressive symptoms and long-term outcomes in those with schizophrenia. This large study spanned 3 years; while participants were evaluated using observational approaches at the start of the study, and at 12-month intervals till the completion of the study.

Research on non-psychotic symptoms associated with schizophrenia is growing. More and more we are seeing how much quality of life changes when patients are treated holistically; treating more than just the “schizophrenia”. Treatment that focuses on emotional, physical, mental, and even spiritual aspects of a person, may deem better results than limiting treatment to a single portion of an individual’s life. This study paints a picture that mood, motivation, and physical symptoms (which are all components of depression) may hinder treatment outcomes for those with schizophrenia.

The researchers concluded: "Treatment of the non-psychotic dimensions of schizophrenia is a critical part of recovery."

The study compared treatment outcomes between people with schizophrenia who were depressed (depression was defined by a score of 16 or greater on the Montgomery-Asberg Depression Rating Scale) and those with schizophrenia who were not depressed. The outcome was rated by participant’s self-report measures, clinicians’ ratings, and medical record information.

When the study began, 39.4% of the participants met the depressed criteria. Over the course of the study, the depressed participants were:

significantly more likely than the Non-depressed to use relapse-related mental health services (emergency psychiatric services, sessions with psychiatrists); to be a safety concern (violent, arrested, victimized, suicidal); to have greater substance-related problems; and to report poorer life satisfaction, quality of life, mental functioning, family relationships, and medication adherence. Furthermore, changes in depressed status were associated with changes in functional outcomes.

People with schizophrenia and concurrent depressive symptoms have poorer long-term functional outcomes compared to the Non-depressed. Their poorer quality of life, greater use of mental health services, and higher risk of involvement with law enforcement agencies underscore a need for special treatment interventions," wrote R.R. Conley and colleagues, University of Maryland, Research Center.

Robert R. Conley, Haya Ascher-Svanum, Baojin Zhu, Douglas E. Faries and Bruce J. Kino
The burden of depressive symptoms in the long-term treatment of patients with schizophrenia. Schizophrenia Research, Volume 90, Issues 1-3, February 2007, Pages 186-197
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