Prevalence, Influencing Factors, and Cognitive Characteristics of Depressive Symptoms in Elderly Patients with Schizophrenia

Yaopian Chen, 1 Wei Li 2, 3 1Department of Sleep Medicine, Wenzhou Seventh People’s Hospital, Wenzhou, People’s Republic of China; 2Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 3Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, People’s Republic of ChinaCorrespondence: Wei LiDepartment of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People’s Republic of ChinaTel +86 021 64387250Email 822203867@qq.comPurpose: To investigate the prevalence, influencing factors, and cognitive characteristics of depressive symptoms in elderly patients with chronic schizophrenia.Patients and Methods: A total of 241 elderly patients with chronic schizophrenia and 156 healthy controls were enrolled in this study. The Geriatric Depression Scale (GDS) was used to assess depressive symptoms; the Positive and Negative Syndrome Scale was used to assess psychotic symptoms; and both the Mini-Mental State Examination and Montreal Cognitive Assessment were used to assess overall cognitive function, while the Activity of Daily Living Scale was used to assess daily living ability.Results: The prevalence of depressive symptoms was 48.5% (117/241) in elderly patients with chronic schizophrenia, which was substantially higher than that of normal controls (17.3%, 27/156). Using a stepwise binary logistic regression analysis, we found that high education (p=0.006, odds ratio [OR]=1.122, 95% confidence interval [CI]:1.034– 1.218) and hypertension (p=0.019, OR=0.519, 95% CI: 0.300– 0.898) were influencing factors for the comorbidity of depressive symptoms. Compared with individuals without depressive symptoms, individuals with depressive symptoms usually display worse overall cognitive function and more severe impairment of activities of daily living, but fewer psychotic symptoms. Interestingly, the GDS score was negatively correlated with the course of the disease (r=− 0.157, p=0.016), suggesting that patients who had recently been admitted to the hospital were more likely to develop depression.Conclusion: Elderly patients with chronic schizophrenia are often associated with higher levels of depression. Therefore, their overall cognitive function is worse, and their activities of daily living are more seriously impaired. Therefore, these patients should be provided with appropriate psychological comfort, especially those who have recently been admitted to the hospital.Keywords: elderly, chronic schizophrenia, depressive symptoms, hypertension, education