Scales for Evaluating Depressive Symptoms in Chinese Patients With Schizophrenia

There have been few studies evaluating depressive symptoms in Chinese patients with schizophrenia. Thus, we planned to compare the diagnostic validity of 4 commonly used assessment scales for depression in schizophrenia in China. The association between different depression scales and between depression scales and negative symptoms were also studied. The study population consisted of 101 inpatients meeting the DSM-IV criteria for schizophrenia. Depression in the study subjects was defined by the DSM-IV criteria for a major depressive episode. The negative subscale of the PANSS was used to assess the negative symptoms in schizophrenia. The following 4 depression scales were assessed for their diagnostic validity as measures of depressive disorder in schizophrenia: the Calgary Depression Scale for Schizophrenia (CDSS), the Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Rating Scale for Depression (HAM-D), and the depression subscale of the PANSS (PANSS-D). The depression scales were found to be highly intercorrelated with each other. Of the 4 depression scales studied, only CDSS can discriminate between depression and a PANSS negative symptoms subscale score or negative item scores. The areas under the receiver operating characteristic curves of the CDSS, HAM-D, MARDS, and PANTSS-D were 0.954, 0.881, 0.828, and 0.897, respectively. The area under the receiver operating characteristic curve of the CDSS was significantly greater than those of the HAM-D, the MARDS, and the PANSS-D. Our study suggests that the CDSS may provide optimal assessment of depression in patients with schizophrenia.