Subsyndromal and Syndromal Depression Among Older Adults With Schizophrenia

The prevalence of subsyndromal or syndromal depressive symptoms (SSSD) was examined among older French adults with schizophrenia spectrum disorder in a study published in the Journal of Affective Disorders. Researchers found that within their sample (N=343), 78.1% were affected with either syndromal (47.5%) or subsyndromal (30.6%) depressive symptoms, although these were not associated with higher utilization of mental health care services, suggesting that depression may be undertreated and underassessed in this population.

Researchers used data from this large, multicenter cohort of individuals with schizophrenia aged 55 years or more to examine the prevalence of SSSD in this French population and its association with clinical characteristics of schizophrenia, sociodemographic characteristics, comorbidity, quality of life and functioning, psychotropic medications, and mental health care utilization. SSSD was defined using the Center for Epidemiologic Studies Depression Scale.

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SSSD were independently associated with lower quality of life, positive and negative symptoms, urbanicity, benzodiazepine use, and nonlate-onset psychosis. No significant association was shown between SSSD and other sociodemographic factors or psychotropic medications, or general medical conditions. No significant difference in the proportion of participants treated with antidepressants was seen between those without depression and those with syndromal depressive symptoms (20.0% vs 22.1%, P =.89), and SSSD were not associated with higher utilization of mental health care.

Although the study was limited due to cross-sectional data and the fact that depression was not evaluated by semistructured interview, study investigators still concluded that SSSD is both likely to be highly prevalent and underassessed and/or undertreated among older patients with schizophrenia spectrum disorder and that their findings “should inform clinicians about the need to systematically and regularly assess depression in all older individuals with schizophrenia.”


Hoertel N, Jaffré C, Pascal de Raykeer R, et al. Subsyndromal and syndromal depressive symptoms among older adults with schizophrenia spectrum disorder: Prevalence and associated factors in a multicenter study. J Affect Disord. 2019;251:60-70.