Depressed mood in first episode psychosis: findings from the “Parma-Early Psychosis” program

Objective
Depressed mood (DM) is relatively frequent in psychosis and significantly associated with suicidal behavior and poorer prognosis. However, it is often under-recognized and under- treated, especially at the illness onset. The aims of this research were: (1) to longitudinally assess DM levels in young subjects with First Episode Psychosis (FEP) over a 2-year follow-up period, and (2) to explore any relevant association of DM with clinical features and the specialized intervention components of an Italian “Early Intervention in Psychosis” (EIP) program, both at baseline and along the follow-up.
Methods
The Positive And Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF) were completed by 266 FEP individuals (aged 12-53 years). Regression analyses with DM as the dependent measure and sociodemographic, psychopathological and treatment characteristics as independent parameters were also performed (both at baseline and along the follow-up).
Results
Relevant DM (i.e. PANSS “Depression” item subscore of ≥ 5) descreased over time and showed longitudinally stable associations with PANSS “Negative Symptoms” and “Positive Symptoms” scores. Along the follow-up, reduction in DM levels was also related to higher antidepressant dose at entry and lower antipsychotic dose prescribed at the end of our research (i.e. after 24 months of follow-up).
Conclusions
Relevant DM is experienced in FEP and in the first specialist contact within specialized EIP programs. However, DM severity levels tends to decrease overtime, together with general improvments in psychosis psychopathology and with antidepressant prescription at entry.