Depressive symptoms in schizophrenia

Patients with schizophrenia suffer frequently from comorbid depressive symptoms. However, there is a paucity of studies regarding prevalence, clinical diagnostic and treatment in the field. For this review, we performed a focused literature analysis to identify recommendation for the treatment and diagnosis of schizophrenia with comorbid depression. Furthermore, we searched different schizophrenia guidelines for specific treatment recommendations. Due to the complex and heterogeneous picture of depressive symptoms in schizophrenia, the application of standardized assessment tools is recommended. For these purposes, the CDSS (Calgary depression rating scale for Schizophrenia) is such an established tool. In summary, there is only limited evidence for specific treatment recommendations. A change in antipsychotic treatment should usually be preferred before an antidepressant is introduced. In the group of antidepressants, SSRI seem to have some advantages, but most clinical and scientific experience is available for tricyclic antidepressants. Due to the limited original contributions and studies with sufficient methodology, further interventional trials are needed to give specific recommendations with high evidence grades.