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Depression, suicidal behavior and insight in adolescents with schizophrenia

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Abstract

Objectives

To investigate the interrelationships between depressive symptoms of adolescent schizophrenia, post-psychotic depression (PPD), negative signs, suicidal behavior and insights into the disease.

Methods

Three groups of 16 adolescent inpatients were assessed with regard to: Schizophrenia alone, schizophrenia with PPD and major depressive disorder (MDD). The following measures were used: DSM IV diagnostic criteria, the Calgary Depression Scale for Schizophrenia (CDSS), the PANSS (Positive and Negative Signs of Schizophrenia Scale), (BDI) Beck Depression Inventory, (CCL) Cognitive Check List, (HS) Hopelessness Scale, (SRS) Suicide Risk Scale, (CSPS) Child Suicide Potential Scale and the (SAUMD) Scale to Assess Unawareness of Mental Disorder.

Results

Compared with MDD adolescents, PPD adolescents showed few somatic and behavioral symptoms of depression but had equally severe cognitive and affective depressive symptomatology. Suicide risk scores and actual suicidal behavior was prominent in PPD adolescents. A positive and significant correlation was found between PPD symptoms, suicide risk and awareness of disease (insight). Negative symptoms of schizophrenia could be distinguished from PPD symptoms and there was a negative correlation between blunted affect and PPD scores.

Conclusions

PPD can be diagnosed in adolescent schizophrenia. The symptom pattern is different from MDD, therefore, there may be cause to modify DSM IV provisional criteria for this condition. Adolescents with schizophrenia who have insight into their illness are at higher risk for suicidal behavior and the development of PPD.

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Authors and Affiliations

  1. Feinberg Child Study Centre, Schneider’s Children’s Medical Centre of Israel, 14 Kaplan St., Petah Tikva, 49202, Israel

    Osnat Schwartz-Stav MA, Alan Apter MD & Gil Zalsman MD

  2. Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel

    Alan Apter MD & Gil Zalsman MD

  3. Child and Adolescent Dept., Geha Mental Health Centre, Israel

    Gil Zalsman MD

Authors
  1. Osnat Schwartz-Stav MA
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  2. Alan Apter MD
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  3. Gil Zalsman MD
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Correspondence to Alan Apter MD.

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Schwartz-Stav, O., Apter, A. & Zalsman, G. Depression, suicidal behavior and insight in adolescents with schizophrenia. Eur Child Adolesc Psychiatry 15, 352–359 (2006). https://doi.org/10.1007/s00787-006-0541-8

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