Clinical and genetic associations of depressive symptoms in paranoid schizophrenia
https://doi.org/10.21886/2219-8075-2025-16-4-28-34
Abstract
Objective: to establish clinical and genetic associations in patients with paranoid schizophrenia with and without depressive manifestations. Materials and methods: patients with paranoid schizophrenia after 10–14 days of inpatient treatment were included. Psychometric methods were used: Calgary Depression Scale for Patients with Schizophrenia (CDSS), PANSS scale, Columbia Suicide Risk Rating Scale (C-SSRS). Genotyping of the HTR2A gene (rs6313) was performed by PCR. Statistical methods: Microsoft Excel, IBM SPSS Statistics 26. Results: depressive manifestations were detected in 31.8% (124/390). The least frequent item was “suicide”, but it was expressed most strongly in a severe degree. Conclusions: 31.8% of respondents with paranoid schizophrenia experienced depressive symptoms. An inverse relationship was found between the severity of the condition and the frequency of depressive symptoms: the most common was the absence of symptoms, while severe symptoms were the least common. Hopelessness demonstrated an association with the HTR2A rs6313 gene (p=0.044). No significant correlations were found when comparing the remaining values on the Calgary Depression Scale.
Supporting agencies: The study did not have sponsorship.
About the Authors
R. I. Sultanova
Chaika-City
Russian Federation
Competing Interests:
Russian Federation
Renata I. Sultanova, psychiatrist
Moscow
Competing Interests:
Authors declares no conflict of interest
V. R. Gashkarimov
Republican Clinical Psychiatric Hospital
Russian Federation
Competing Interests:
Russian Federation
Vadim R. Gashkarimov, psychiatrist
Ufa
Competing Interests:
Authors declares no conflict of interest
K. A. Gasenko
N.N. Solodnikov Clinical Psychiatric Hospital
Russian Federation
Competing Interests:
Russian Federation
Gasenko A. Ksenia, psychiatrist, head of the department
Omsk
Competing Interests:
Authors declares no conflict of interest
I. S. Efremov
Psychotherapy Workshop
Russian Federation
Competing Interests:
Russian Federation
Ilya S. Efremov, Cand. Sci. (Med.), psychiatrist, psychotherapist, curator
Ufa
Competing Interests:
Authors declares no conflict of interest
A. R. Asadullin
V.M. Bekhterev National Medical Research Center of Psychiatry and Neurology; Bashkir State Medical University; Ufa University of Science and Technology; Saratov State Medical University named after V.I. Razumovsky; Tashkent Medical Academy
Russian Federation
Competing Interests:
Russian Federation
Azat R. Asadullin, Dr. Sci. (Med.), Professor, Department of Psychiatry, Narcology and Psychotherapy; Director of the Center for Molecular medicine; Leading Researcher; Professor, Department of Psychiatry, Narcology, Psychotherapy and clinical psychology; Professor of the Department of Psychiatry and Narcology
Saint Petersburg; Ufa; Saratov; Tashkent
Competing Interests:
Authors declares no conflict of interest
References
1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington: American Psychiatric Publishing; 2013. https://doi.org/10.1176/appi.books.9780890425596
2. ICD-11 for mortality and morbidity statistics. 2018. URL: https://icd.who.int/browse/2018/mms/en
3. Siris SG, Bench C. Depression and schizophrenia. In: Schizophrenia. 2003.
4. Ostroglazov VG. Masked depression in outpatient facilities of the general medical health network. S.S. Korsakov J Neurol Psychiatry. 1979;79(4):438-44. (In Russ.).
5. Mazo G.E.,. Ganzenko M.A, Rukavishnikov G.V., Kas'yanov E.D. Depressiya pri shizofrenii: podkhody k terapii: metodicheskie rekomendatsii. NMITs PN im. V.M. Bekhtereva. 2020. (In Russ.). https://bekhterev.ru/wp-content/uploads/2021/05/04-mr2020-mazo-i-soavt.pdf
6. Hettige NC, Bani-Fatemi A, Sakinofsky I, De Luca V. A biopsychosocial evaluation of the risk for suicide in schizophrenia. CNS Spectr. 2018;23(4):253-263. https://doi.org/10.1017/S1092852917000128
7. Nasyrova R.F., Schnaider N.A., Mironov K.O., Shipulin G.A., Dribnokhodova O.P., et al. Pharmacogenetics of schizophrenia in real clinical practice: a clinical case. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(4):88-93. (In Russ.) https://doi.org/10.14412/2074-2711-2018-4-88-93
8. van Rooijen G, Vermeulen JM, Ruhé HG, de Haan L. Treating depressive episodes or symptoms in patients with schizophrenia. CNS Spectr. 2019;24(2):239-248. https://doi.org/10.1017/S1092852917000554
9. Naguy A. Depression in schizophrenia - A good or bad omen? Asia Pac Psychiatry. 2018;10(2):e12312. https://doi.org/10.1111/appy.12312
10. Mosolov SN, Tsukarzi EE. Psychopharmacotherapy of schizophrenia. In: Psihiatriya: nacional'noe rukovodstvo. 2018. (In Russ.).
11. Maslenikov N., Tsukarzi E., Mosolov S. Algorithm of Biological Treatment for Depression in Schizophrenia. Current Therapy of Mental Disorders. 2019;(2):31–40. (In Russ.) https://doi.org/10.21265/PSYPH.2019.34.92.005
12. Edwards CJ, Garety P, Hardy A. The relationship between depressive symptoms and negative symptoms in people with non-affective psychosis: a meta-analysis. Psychol Med. 2019;49(15):2486-2498. https://doi.org/10.1017/S0033291719002381
13. Guessoum SB, Le Strat Y, Dubertret C, Mallet J. A transnosographic approach of negative symptoms pathophysiology in schizophrenia and depressive disorders. Prog Neuropsychopharmacol Biol Psychiatry. 2020;99:109862. https://doi.org/10.1016/j.pnpbp.2020.109862
14. Correll CU, Schooler NR. Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment. Neuropsychiatr Dis Treat. 2020;16:519-534. https://doi.org/10.2147/NDT.S225643
15. Krynicki CR, Upthegrove R, Deakin JFW, Barnes TRE. The relationship between negative symptoms and depression in schizophrenia: a systematic review. Acta Psychiatr Scand. 2018;137(5):380-390. https://doi.org/10.1111/acps.12873
16. Demyttenaere K, Anthonis E, Acsai K, Correll CU. Depressive Symptoms and PANSS Symptom Dimensions in Patients With Predominant Negative Symptom Schizophrenia: A Network Analysis. Front Psychiatry. 2022;13:795866. https://doi.org/10.3389/fpsyt.2022.795866
17. Xu J, Jiao Y, Xing M, Lin Y, Su Y, et al. Increased plasma leptin as a novel predictor for psychopathological depressive symptoms in chronic schizophrenia. Gen Psychiatr. 2018;31(3):e100018. https://doi.org/10.1136/gpsych-2018-100018
18. Henriksen MG, Nordgaard J, Jansson LB. Genetics of Schizophrenia: Overview of Methods, Findings and Limitations. Front Hum Neurosci. 2017;11:322. https://doi.org/10.3389/fnhum.2017.00322
19. Fang X, Chen Y, Wang Y, Ren J, Zhang C. Depressive symptoms in schizophrenia patients: A possible relationship between SIRT1 and BDNF. Prog Neuropsychopharmacol Biol Psychiatry. 2019;95:109673. https://doi.org/10.1016/j.pnpbp.2019.109673
20. Shkundin A, Halaris A. Associations of BDNF/BDNF-AS SNPs with Depression, Schizophrenia, and Bipolar Disorder. J Pers Med. 2023;13(9):1395. https://doi.org/10.3390/jpm13091395
21. Lu G, Li J, Zhang H, Zhao X, Yan LJ, Yang X. Role and Possible Mechanisms of Sirt1 in Depression. Oxid Med Cell Longev. 2018;2018:8596903. https://doi.org/10.1155/2018/8596903
22. Wang D, Tang W, Zhao J, Fan W, Zhang Y, Zhang C. A Comprehensive Analysis of the Effect of SIRT1 Variation on the Risk of Schizophrenia and Depressive Symptoms. Front Genet. 2020;11:832. https://doi.org/10.3389/fgene.2020.00832
23. Broniarczyk-Czarniak M, Szemraj J, Śmigielski J, Gałecki P. The Role of OXT, OXTR, AVP, and AVPR1a Gene Expression in the Course of Schizophrenia. Curr Issues Mol Biol. 2022;44(1):336-349. https://doi.org/10.3390/cimb44010025
24. Hughes ZH, Hughes LM, Khan SS. Genetic contributions to risk of adverse pregnancy outcomes. Curr Cardiovasc Risk Rep. 2023;17(11):185-193. https://doi.org/10.1007/s12170-023-00729-y
25. Li W. Association of APOE E2 and low-density lipoprotein with depressive symptoms in Chinese senile schizophrenia inpatients: A cross-sectional study. Schizophr Res Cogn. 2020;23:100193. https://doi.org/10.1016/j.scog.2020.100193
26. Sullivan PF, Kendler KS, Neale MC. Schizophrenia as a complex trait: evidence from a meta-analysis of twin studies. Arch Gen Psychiatry. 2003;60(12):1187-1192. https://doi.org/10.1001/archpsyc.60.12.1187
27. Peitl V, Štefanović M, Karlović D. Depressive symptoms in schizophrenia and dopamine and serotonin gene polymorphisms. Prog Neuropsychopharmacol Biol Psychiatry. 2017;77:209-215. https://doi.org/10.1016/j.pnpbp.2017.04.011
28. Selvaraj S, Arnone D, Cappai A, Howes O. Alterations in the serotonin system in schizophrenia: a systematic review and meta-analysis of postmortem and molecular imaging studies. Neurosci Biobehav Rev. 2014;45:233-245. https://doi.org/10.1016/j.neubiorev.2014.06.005
29. Sher L, Kahn RS. Suicide in Schizophrenia: An Educational Overview. Medicina (Kaunas). 2019;55(7):361. https://doi.org/10.3390/medicina55070361
30. Bosanac P, Castle DJ. Schizophrenia and depression. Med J Aust. 2013;199(S6):S36-9. https://doi.org/10.5694/mja12.10516
31. Hayes RD, Chang CK, Fernandes A, Begum A, To D, et al. Associations between symptoms and all-cause mortality in individuals with serious mental illness. J Psychosom Res. 2012;72(2):114-119. https://doi.org/10.1016/j.jpsychores.2011.09.012
32. Zhang JP, Lencz T, Zhang RX, Nitta M, Maayan L, et al. Pharmacogenetic Associations of Antipsychotic DrugRelated Weight Gain: A Systematic Review and Metaanalysis. Schizophr Bull. 2016;42(6):1418-1437. https://doi.org/10.1093/schbul/sbw058
33. Ivashchenko D.V., Buromskaya N.I., Shimanov P.V., Deich R.V., Nastovich M.I., et al. HTR2A rs6313 polymorphic variant is associated with adverse effects to antipsychotics in adolescents with an acute psychotic episode Farmateka. 2021;28(9):45–51. (In Russ.). https://doi.org/10.18565/pharmateca.2021.9.45-51
34. Massoud S, Salmanian M, Tabibian M, Ghamari R, Tavabe Ghavami TS, Alizadeh F. The contribution of the 5-hydroxytryptamine receptor 2 A gene polymorphisms rs6311 and rs6313 to Schizophrenia in Iran. Mol Biol Rep. 2023;50(3):2633-2639. https://doi.org/10.1007/s11033-022-08222-2
35. Maffioletti E, Valsecchi P, Minelli A, Magri C, Bonvicini C, et al. Association study between HTR2A rs6313 polymorphism and early response to risperidone and olanzapine in schizophrenia patients. Drug Dev Res. 2020;81(6):754-761. https://doi.org/10.1002/ddr.2
Review
For citations:
Sultanova R.I., Gashkarimov V.R., Gasenko K.A., Efremov I.S., Asadullin A.R. Clinical and genetic associations of depressive symptoms in paranoid schizophrenia. Medical Herald of the South of Russia. 2025;16(4):28-34. (In Russ.) https://doi.org/10.21886/2219-8075-2025-16-4-28-34
Views:
39
Email this article 