Treatment aspects of youth depression with attenuated schizophrenic symptoms

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OBJECTIVE

To analyze main aspects of the treatment of patients with youth depression with attenuated schizophrenic symptoms (ASS).

MATERIAL AND METHODS

Two hundred and nineteen young in-patients (median age 19.6±2.4) with the first depressive episode (F32.1, F32.2, F32.38, F32.8.) and ASS were examined. The comparison group included 52 patients with depression without ASS with similar socio-demographic and age characteristics (average age 19.8±2.7 years). The efficacy of the therapy was assessed by the reduction of HDRS, SOPS and SANS scores. The Drug Compliance Scale was used to assess the compliance of patients.

RESULTS

The average duration of in-patient treatment did not differ between groups (56.3 days in the main group and 54.2 days in the comparison group). The most effective therapy was found in the depression reduction on HDRS (67.9% and 76.6% respectively), the ASS reduction was 46.1% on the SOPS and 31.2% on the SANS. The combination of antidepressants (46.0±28.9 mg/day for fluoxetine equivalents) and antipsychotics (385.4±210.7 mg/day for chlorpromazine equivalents) were required to achieve this efficacy. The average duration of continued treatment was 7.4±9.6 months that was significantly lower (p<0.05) than in the comparison group (11.7±9.0 months), which was determined by the low compliance of such patients.

CONCLUSION

The results show that a combination treatment and the implementation of measures, increasing the degree of compliance are required to increase the efficacy of treatment in patients with youth depression and ASS.

Keywords:

attenuated symptoms of schizophrenia

high-risk psychosis group

preventive treatment

youth depression

Authors:

Omelchenko M.A.

Mental Health Research Centre

SPIN RSCI: 1643-9032
Scopus AuthorID: 35773602800
ResearcherID: K-6508-2016
ORCID: 0000-0001-8343-168X

Received:

19.01.2022

Accepted:

01.02.2022

List of references:

Fusar-Poli P. The Clinical High-Risk State for Psychosis (CHR-P), Version II. Schizophr Bull. 2017;43(1):44-47. https://doi.org/10.1093/schbul/sbw158
Woodberry KA, Shapiro DI, Bryant C, Seidman LJ. Progress and Future Directions in Research on the Psychosis Prodrome: A Review for Clinicians. Harv Rev Psychiatry. 2016;24(2):87-103. https://doi.org/10.1097/HRP.0000000000000109
Bykowsky O, Harrisberger F, Schmidt A, et al. Association of antidepressants with brain morphology in early stages of psychosis: an imaging genomics approach. Sci Rep. 2019;9:8516. https://doi.org/10.1038/s41598-019-44903-y
Hatton SN, Lagopoulos J, Hermens DF, Scott E, Hickie IB, Bennett MR. Cortical thinning in young psychosis and bipolar patients correlate with common neurocognitive deficits. Int J Bipolar Disord. 2013;1:3. Published 2013 Apr 17. https://doi.org/10.1186/2194-7511-1-3
Davies C, Radua J, Cipriani A, Stahl D, Provenzani U, McGuire P, Fusar-Poli P. Efficacy and Acceptability of Interventions for Attenuated Positive Psychotic Symptoms in Individuals at Clinical High Risk of Psychosis: A Network Meta-Analysis. Front Psychiatry. 2018;9:187. PMID: 29946270. https://doi.org/10.3389/fpsyt.2018.00187
Goulding SM, Holtzman CW, Trotman HD, et al. The prodrome and clinical risk for psychotic disorders. Child Adolesc Psychiatr Clin N Am. 2013;22(4):557-567. https://doi.org/10.1016/j.chc.2013.04.002
Correll CU, Schooler NR. Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment. Neuropsychiatr Dis Treat. 2020;16:519-534. Published 2020 Feb 21. https://doi.org/10.2147/NDT.S225643
Duric V, Banasr M, Franklin T, et al. Cariprazine Exhibits Anxiolytic and Dopamine D3 Receptor-Dependent Antidepressant Effects in the Chronic Stress Model. Int J Neuropsychopharmacol. 2017;20(10):788-796. https://doi.org/10.1093/ijnp/pyx038
Mosolov SN, Yaltonskaya PA. Algorithm for the Treatment of Primary Negative Symptoms in Schizophrenia. Sovrem Ter Psih Rasstrojstv. 2020;2:2-10.(In Russ.). https://doi.org/10.21265/PSYPH.2020.26.17.001
van der Gaag M, Smit F, Bechdolf A, French P, Linszen DH, Yung AR, McGorry P, Cuijpers P. Preventing a first episode of psychosis: meta-analysis of randomized controlled prevention trials of 12 month and longer-term follow-ups. Schizophr Res. 2013;149(1-3):56-62. https://doi.org/10.1016/j.schres.2013.07.004
Omelchenko MA. Clinical Features of Youth Depression with Attenuated Symptoms of the Schizophrenic Spectrum. Psikhiatriya. 2021;19(1):16-25. (In Russ.).
Lutova NB, Borcov AV, Vuks AYa, Vid VD. Metod prognozirovaniya medikamentoznogo komplajensa v psihiatrii. Metodicheskie rekomendacii. SPb.: NIPNI im. V.M. Bekhtereva; 2007. (In Russ.).
Hayasaka Y, Purgato M, Magni LR, et al. Dose equivalents of antidepressants: Evidence-based recommendations from randomized controlled trials. J Affect Disord. 2015;180:179-184. https://doi.org/10.1016/j.jad.2015.03.021
Olejchik IV. Endogennye depressii v yunosheskom vozraste: psihopatologicheskie osobennosti, tipologicheskaya differenciaciya, nozologicheskaya ocenka, voprosy terapii. Doktor.Ru. 2008;4(41):64-68. (In Russ.).
Targownik LE, Bolton JM, Metge CJ, et al. Selective serotonin reuptake inhibitors are associated with a modest increase in the risk of upper gastrointestinal bleeding. Am J Gastroenterol. 2009;104(6):1475-1482. https://doi.org/10.1038/ajg.2009.128
Leucht S, Samara M, Heres S, et al. Dose Equivalents for Antipsychotic Drugs: The DDD Method. Schizophr Bull. 2016;42(suppl 1):90-94. https://doi.org/10.1093/schbul/sbv167
Janjic V, Borovcanin M, Dejanovic S, Muric N, Radmanovic B. PM391. The use of amisulpride in treatment of patients with residual schizophrenia. International Journal of Neuropsychopharmacology. 2016;19(suppl 1):43. https://doi.org/10.1093/ijnp/pyw041.391
Woodward ND, Purdon SE, Meltzer HY, et al. A meta-analysis of neuropsychological change to clozapine, olanzapine, quetiapine, and risperidone in schizophrenia. Int J Neuropsychopharmacol. 2005;8(3):457-472. https://doi.org/10.1017/S146114570500516X
Goozee R, Reinders AATS, Handley R, et al. Effects of aripiprazole and haloperidol on neural activation during the n-back in healthy individuals: A functional MRI study. Schizophr Res. 2016;173(3):174-181. https://doi.org/10.1016/j.schres.2015.02.023
Urben S, Baumann P, Barcellona S, et al. Cognitive efficacy of quetiapine in early-onset first-episode psychosis: a 12-week open label trial. Psychiatr Q. 2012;83(3):311-324. https://doi.org/10.1007/s11126-011-9201-3
Nishiyama A, Matsumoto H. Quetiapine reduces irritability and risk of suicide in patients with agitated depression. The Tokai Journal of Experimental and Clinical Medicine. 2013;38:2:93-96.
Blier P, Keller MB, Pollack MH, et al. Preventing recurrent depression: long-term treatment for major depressive disorder. J Clin Psychiatry. 2007;68(3):e06.
Sim K, Lau WK, Sim J, et al. Prevention of Relapse and Recurrence in Adults with Major Depressive Disorder: Systematic Review and Meta-Analyses of Controlled Trials [published correction appears in Int J Neuropsychopharmacol. 2016 Apr 27]. Int J Neuropsychopharmacol. 2015;19(2):pyv076. Published 2015 Jul 7.
Forte A, Baldessarini RJ, Tondo L, et al. Long-term morbidity in bipolar-I, bipolar-II, and unipolar major depressive disorders. J Affect Disord. 2015;178:71-78. https://doi.org/10.1016/j.jad.2015.02.011
Baldessarini RJ. Chemotherapy in Psychiatry. 3rd ed. New York: Springer Press; 2013.
Oluboka OJ, Katzman MA, Habert J, et al. Functional Recovery in Major Depressive Disorder: Providing Early Optimal Treatment for the Individual Patient. Int J Neuropsychopharmacol. 2018;21(2):128-144. https://doi.org/10.1093/ijnp/pyx081

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