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Depression in Schizophrenia: Methodological Artifact or Distinct Feature of the Illness?

Received May 11, 2007; revised July 30, 2007; accepted August 14, 2007. Drs. Chemerinski, Bowie, and Ms. Anderson are affiliated with the Department of Psychiatry at Mount Sinai School of Medicine in New York; Dr. Chemerinski is also affiliated with the Veterans Association, VISN 3 Mental Illness Research Education and Clinical Center (MIRECC), in New York. Dr. Harvey is affiliated with the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine in Atlanta. Address correspondence to Eran Chemerinski, M.D., VA VISN 3 Mental Illness Research, Education and Clinical Center, 130 West Kingsbridge Rd., Bronx, NY 10468; eran.chemerinski{at}mssm.edu (e-mail).

In schizophrenia, there is a conceptual overlap between depressive and negative symptoms. This study examined the dimensional structure of depressive symptoms and their overlap with negative symptoms in a large sample of older medicated schizophrenia outpatients. Self-reported depression was obtained with the Beck Depression Inventory-II (BDI-II). Three components from this scale (i.e., dysphoria, psychosomatic and regret domains) showed excellent factorability and good consistency. However, adequate construct validity and correlates with outcomes were found for the dysphoria and regret domains, but not for the total score or the psychosomatic domain. Thus, the evaluation of domains within the BDI-II provides a more pure and clinically-relevant assessment of depressed mood in schizophrenia than the use of this scale as a whole.

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