Targeted treatment for depression could benefit patients with psychosis

Targeted treatment for depression could benefit patients with psychosis

Last Reviewed : 01/05/2021
Targeted treatment for depression could benefit patients with psychosis

Press Release: 

  • Patients with early onset psychosis may benefit from treatment for depression, including with anti-depressants alongside other medication, new research shows.


According to scientists at the University of Birmingham's Institute for Mental Health, depression may be an intrinsic part of early phase psychotic disorders that should be treated together with other more prominent symptoms to improve patient outcomes.

Depression is often identified alongside psychotic disorders such as schizophrenia in the early stages of the disorder, but is not currently routinely treated. In a new study, published in Schizophrenia Bulletin, the researchers set out to find out more about the associations between depression and psychosis, and particularly whether there were similarities in brain structure that could help future diagnostic pathways at an early stage.

Data was gathered from 1700 patients as part of the PRONIA study, a largescale European study which uses machine learning to find ways to predict how people with recent onset psychosis might recover.

The team used demographic and clinical data along with detailed symptom measures and neuroimaging information from a structural MRI scan from participants with recent onset psychosis and recent onset depression. They interrogated the data using machine learning software to try to find out whether it was possible to identify a subgroup of patients with distinct symptoms of both depression and psychosis.

Their results showed that, in fact, there was little difference in either the patients' depressive symptoms or in the structural brain changes in patients with depression, with and without psychosis. This shows that there is no subgroup of patients with both depression and psychosis, but rather that depression may be an intrinsic part of a majority of patients' psychosis.

The team argue their findings show that treatments focused on depression may well be an effective additional first-line treatment for psychosis, to be given alongside regular interventions.

We know that depression in patients with schizophrenia frequently leads to poorer outcomes, and so understanding how treatment such as antidepressant might be used to improve these outcomes could be a big step forward.

The team has already embarked on a clinical trial to test the approach in patients. The ADEPP trial will test people in the first stages of psychosis who take anti-depressants alongside anti-psychotic drugs. The trial will assess over a six month period whether the anti-depressants have an effect on the patients' ability to recover from their psychosis.


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Materials provided by University of BirminghamNote: Content may be edited for style and length.

Journal Reference:

  1. Nikolaos Koutsouleris, Stephen J Wood, Eva Meisenzahl, Raimo K R Salokangas, Frauke Schultze-Lutter, Stephan Ruhrmann, Christos Pantelis, Rebekka Lencer, Joseph Kambeitz, Stefan Borgwardt, Paolo Brambilla, Alessandro Bertolino, Lana Kambeitz-llankovic, Nora Penzel, Theresa Haidl, Marian Surman, Dominic B Dwyer, Anne Ruef, Marlene Rosen, Alexandra Stainton, Renate Reniers, Mirabel Pelton, Mariam Iqbal, Sian Lowri Griffiths, Katharine Chisholm, Pavan Mallikarjun, Paris Lalousis, Rachel Upthegrove. The Psychopathology and Neuroanatomical Markers of Depression in Early PsychosisSchizophrenia Bulletin, 2020; DOI: 10.1093/schbul/sbaa094

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