Symptoms of depression in middle-aged and older adults with schizophrenia in Guangzhou, China: a cross-sectional study

Junrong Ye¹Jialan Wu²Lingli Lei²Dandan Zheng³Yanheng Wei¹Dingjie Liu⁴Xueyu Zheng⁴Jinrong Li⁴Na Ma⁴Yuhan Zhang⁴Jiao Chen⁴Jianxiong Guo^5*Aixiang Xiao^1*

• ¹Department of Nursing, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
• ²Department of Geriatric Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
• ³Department of Nursing, The Fifth People's Hospital of Nanning, Nanning, China
• ⁴School of Nursing, Guangzhou Medical University, Guangzhou, China
• ⁵Department of Chronic Disease, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China

Objective This study aims to explore the prevalence and risk factors of symptoms of depression in middle-aged and older adults with schizophrenia. Methods In this cross-sectional study, 116 participants were recruited from a tertiary psychiatric hospital in Guangzhou, China. The sample consisted of adults aged 40 years and over. Based on their scores on the Geriatric Depression Scale, participants with schizophrenia were categorized into two groups: those with depressive symptoms (scores greater than 10 points) and those without depressive symptoms (scores of 10 points or lower). This study compared the differences in sociodemographic variables (such as gender, age, education level, marital status, BMI) and clinical characteristics (suicide risk, anxiety level, severity of mental symptoms, insight into illness and treatment attitude, cognitive function, activities of daily living, quality of life, and social support) between two groups. Spearman correlation analysis and logistic regression analysis were employed to explore the relevant factors contributing to depression in middle-aged and older adults with schizophrenia. Result: The participants had an average age of 63.28 ± 7.87 years, and 88 of participants (75.9%) were female. Among these, thirty-four participants (29.31%) exhibied symptoms of depression. Statistically significant differences were observed between the two groups in the sub-dimension of |affect and resistance on the Brief Psychiatric Rating Scale (BPRS), the total score of Generalized Anxiety Disorder (GAD) assessment, the Insight and Treatment Attitudes Questions, the Nurses' Global Assessment of Suicide Risk, and the Schizophrenia Quality of Life Scale (SQLS). Furthermore, logistics regression indicated that the resistance sub-dimension of BPRS (OR = 0.790, 95% CI: 0.648 - 0.963), the SQLS (OR = 1.115, 95% CI: 1.055 - 1.178) and the GAD score (OR = 1.205, 95% CI: 1.029 - 1.412) were precidictor factors for symptoms of depression in individuals with schizophrenia. Conclusion: In middle-aged and older adults with schizophrenia, affective symptoms and quality of life are associated with symptoms of depression.