Depressive symptoms in a sample of Egyptian patients with schizophrenia on antipsychotic medications

Abstract Background Depressive symptoms are frequently observed among individuals with schizophrenia and are linked to unfavorable clinical outcomes, including functional impairment and a higher likelihood of relapse. However, they are frequently underrecognized in routine clinical practice. Aim To determine the severity of depressive symptomatology and suicidal ideation in patients diagnosed with schizophrenia and to examine their association with the type of antipsychotic medication used. Methods This cross-sectional study included 92 patients with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Depressive symptoms were evaluated using the Hamilton Depression Rating Scale (HAM-D), and suicidal ideation was evaluated using Beck’s Scale for Suicide Ideation. Patients were categorized into two groups based on antipsychotic treatment used: typical and atypical. Results The mean HAM-D score was 6.9 ± 4.3, with 87% of patients exhibiting minimal to mild depressive symptoms. Suicidal ideation was present in 3.3% of patients. Patients receiving typical antipsychotics had significantly higher depression scores compared to those receiving atypical antipsychotics (median = 8 vs. 5, p = 0.002). Patients on atypical antipsychotics had a higher number of previous hospitalizations ( p = 0.026). No significant associations were found between depressive symptoms and most sociodemographic variables, except for gender. Conclusion Depressive symptoms are common in patients with schizophrenia, even when predominantly mild. Patients receiving typical antipsychotics demonstrated higher HAM-D scores than those receiving atypical antipsychotics; however, the cross-sectional design precludes conclusions regarding temporal or causal relationships. The low prevalence of suicidal ideation limits conclusions regarding suicidality. Routine screening for depressive symptoms should be integrated into clinical care.