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Course, correlates and predictors of depression in schizophrenia
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with orientation in the Rivermead Memory Test and with MMSE. However, the Reality Distorsion syndrome showed no correlations. In conclusion, a three-factor solution was found also in this highly selected group. The factors appeared to correlate differently with clinical parameters.
IV.A.7 CHOOSING A NEGATIVE RATING SCALE
SYMPTOM
Style Questionnaire (ASQ) and level of depression. Mean depression scores decreased over the follow-up period, but a subgroup of 14 (15.2%) subjects experienced clinically significant increases in level of depression. Two factors were associated with increased depression, higher education (risk ratio = 2.13) and being employed (risk ratio 2.13). Scoring above the sample median on the positive composite ASQ scale appeared to be protective (risk ratio 0.65). Combination of these variables into multiple logistic regression models provided a good description of the observed risk in the sample. For the group as a whole treatment of the relapse is the most important factor for reducing level of depression. It may be possible to prospectively identify patients at risk of developing depression.
J. Welham*, G. Smith**, T. S t e d m a n * a n d A. Clair*
*Clinical Studies Unit, Wolston Park Hospital, Wacol, Q4076, Australia, **Department of Psychology, University of Queensland, Q4072, Australia Problems have been raised with the use of overlapping psychometric scales to measure negative symptoms in schizophrenia. We compared the negative symptom subscales of the BPRS (BPRS-WR) and the PANSS (PANSS-NS), and the complete SANS on the basis of both association and redundancy, and also level of data reduction, ie total scores, subscale score and individual items. We found that the relationship between the scales depended on both the method of analysis and the level of data reduction. While the BPRS, PANSS and SANS total scores were highly intercorrelated, when subsequently examined in terms of redundancy the individual items and subscale scores of the SANS contained information independent of the BPRS-WR, and also, to a lesser extent, the PANSS-NS. The best BPRS-WR and PANSS-NS predictor variates explained only about half the SANS variance. When the SANS was represented by a single variable (composite score) however, it became highly redundant with the BPRS-WR and, to a lesser extent, the PANSS-NS totals. The inter- and intra-set loadings for the various items produced by the redundancy analysis also provides useful information for the choice of negative symptom scale.
IV.B. Depression and suicidal behavior
IV.B.2 SUICIDAL BEHAVIOR SCHIZOPHRENIA
AND INSIGHT
IN
X.F. A m a d o r , J.H. Friedman, M. F l a u m a n d J.M. Gorman
Columbia University Department of Psychiatry, 722 West 168 Street Unit2 New York, N Y lO032 U.S.A. Suicidal behavior is prevalent in schizophrenia. Although a relationship between increased awareness of illness and suicidal behavior has been posited, the question has not been systematically studied. The purpose of this study was to examine the relations between suicidal behavior and various aspects of insight in a sample of 218 patients with schizophrenia. Patients participating in the DSM IV Field Trial for Schizophrenia were studied with the Scale to assess Unawareness of Mental Disorder and an instrument developed for the field trial study that measured multiple aspects of psychopathology including suicidal behavior. The prevalence of suicidal thoughts and behavior found in this study is consistent with previous published reports. Of the 218 participants, 49 (22.4%) reported recent or current suicidal behavior while 169 (77.5%) did not. Schizophrenia patients with recurrent suicidal thoughts and behavior were generally more aware of their negative symptoms and of delusions than were the nonsuicidal patients. Contrary to expectations, awareness of having a mental disorder more generally, did not predict suicidal behavior.
IV.B.1 COURSE, CORRELATES AND PREDICTORS OF DEPRESSION IN SCHIZOPHRENIA D. A d d i n g t o n , J. A d d i n g t o n a n d S. P a t t e n
Department of Psychiatry, University of Calgary. Foothills Hospital, 1403 29 Street N. W., Calgary, Alberta, Canada, T2N 2T9 The purpose of this study was to examine potential predictors of depression at a time of relapse and at three months followup in 113 subjects with schizophrenia. At time one, but not at follow-up, a statistically significant correlation was observed between the negative attributions subscale of the Attributional
IV.B.3 NEUROPSYCHOLOGICAL AND DEFENSIVE ASPECTS OF POOR INSIGHT AND DEPRESSION IN SCHIZOPHRENIA C. Kasapis, X.F. A m a d o r , S.A. Yale, D.H. Strauss a n d J.M. G o r m a n
New York State Psychiatric Institute, 722 West 168th Street Unit #2, New York, N Y lO032, U.S.A. Research indicates that a majority of patients with schizophrenia have poor insight. We have suggested that these deficits
with orientation in the Rivermead Memory Test and with MMSE. However, the Reality Distorsion syndrome showed no correlations. In conclusion, a three-factor solution was found also in this highly selected group. The factors appeared to correlate differently with clinical parameters.
IV.A.7 CHOOSING A NEGATIVE RATING SCALE
SYMPTOM
Style Questionnaire (ASQ) and level of depression. Mean depression scores decreased over the follow-up period, but a subgroup of 14 (15.2%) subjects experienced clinically significant increases in level of depression. Two factors were associated with increased depression, higher education (risk ratio = 2.13) and being employed (risk ratio 2.13). Scoring above the sample median on the positive composite ASQ scale appeared to be protective (risk ratio 0.65). Combination of these variables into multiple logistic regression models provided a good description of the observed risk in the sample. For the group as a whole treatment of the relapse is the most important factor for reducing level of depression. It may be possible to prospectively identify patients at risk of developing depression.
J. Welham*, G. Smith**, T. S t e d m a n * a n d A. Clair*
*Clinical Studies Unit, Wolston Park Hospital, Wacol, Q4076, Australia, **Department of Psychology, University of Queensland, Q4072, Australia Problems have been raised with the use of overlapping psychometric scales to measure negative symptoms in schizophrenia. We compared the negative symptom subscales of the BPRS (BPRS-WR) and the PANSS (PANSS-NS), and the complete SANS on the basis of both association and redundancy, and also level of data reduction, ie total scores, subscale score and individual items. We found that the relationship between the scales depended on both the method of analysis and the level of data reduction. While the BPRS, PANSS and SANS total scores were highly intercorrelated, when subsequently examined in terms of redundancy the individual items and subscale scores of the SANS contained information independent of the BPRS-WR, and also, to a lesser extent, the PANSS-NS. The best BPRS-WR and PANSS-NS predictor variates explained only about half the SANS variance. When the SANS was represented by a single variable (composite score) however, it became highly redundant with the BPRS-WR and, to a lesser extent, the PANSS-NS totals. The inter- and intra-set loadings for the various items produced by the redundancy analysis also provides useful information for the choice of negative symptom scale.
IV.B. Depression and suicidal behavior
IV.B.2 SUICIDAL BEHAVIOR SCHIZOPHRENIA
AND INSIGHT
IN
X.F. A m a d o r , J.H. Friedman, M. F l a u m a n d J.M. Gorman
Columbia University Department of Psychiatry, 722 West 168 Street Unit2 New York, N Y lO032 U.S.A. Suicidal behavior is prevalent in schizophrenia. Although a relationship between increased awareness of illness and suicidal behavior has been posited, the question has not been systematically studied. The purpose of this study was to examine the relations between suicidal behavior and various aspects of insight in a sample of 218 patients with schizophrenia. Patients participating in the DSM IV Field Trial for Schizophrenia were studied with the Scale to assess Unawareness of Mental Disorder and an instrument developed for the field trial study that measured multiple aspects of psychopathology including suicidal behavior. The prevalence of suicidal thoughts and behavior found in this study is consistent with previous published reports. Of the 218 participants, 49 (22.4%) reported recent or current suicidal behavior while 169 (77.5%) did not. Schizophrenia patients with recurrent suicidal thoughts and behavior were generally more aware of their negative symptoms and of delusions than were the nonsuicidal patients. Contrary to expectations, awareness of having a mental disorder more generally, did not predict suicidal behavior.
IV.B.1 COURSE, CORRELATES AND PREDICTORS OF DEPRESSION IN SCHIZOPHRENIA D. A d d i n g t o n , J. A d d i n g t o n a n d S. P a t t e n
Department of Psychiatry, University of Calgary. Foothills Hospital, 1403 29 Street N. W., Calgary, Alberta, Canada, T2N 2T9 The purpose of this study was to examine potential predictors of depression at a time of relapse and at three months followup in 113 subjects with schizophrenia. At time one, but not at follow-up, a statistically significant correlation was observed between the negative attributions subscale of the Attributional
IV.B.3 NEUROPSYCHOLOGICAL AND DEFENSIVE ASPECTS OF POOR INSIGHT AND DEPRESSION IN SCHIZOPHRENIA C. Kasapis, X.F. A m a d o r , S.A. Yale, D.H. Strauss a n d J.M. G o r m a n
New York State Psychiatric Institute, 722 West 168th Street Unit #2, New York, N Y lO032, U.S.A. Research indicates that a majority of patients with schizophrenia have poor insight. We have suggested that these deficits