Objective: The present study aimed to investigate the associations between residual symptoms of depression and specific self-reported symptoms in several cognitive domains.

Methods: The study investigated 117 patients with partially or fully remitted major depressive disorder (MDD) after treatment with antidepressant medications.

Results: Fatigue was significantly associated with inability to focus, alertness, and feeling “blue”; low interest and difficulty with concentration were associated with apathy. No associations were found between deficits in the cognitive domains considered and residual symptoms such as self-blaming, feeling worthless, feeling hopeless, having suicidal thoughts, difficulty with sleep, and lack of appetite.

Conclusion: Among MDD remitted patients endorsing residual symptoms such as fatigue and feeling “blue”, deficits in a range of cognitive domains should be carefully assessed and treated.

Introduction: This 52-week open-label extension (OLE) to a double-blind placebo-controlled recurrence prevention study examined the long-term safety and efficacy of flexibly-dosed paliperidone extended-release (ER) tablets in patients with schizophrenia.

Methods: Patients entering the OLE either entered from the double-blind phase (placebo or paliperidone ER treatment) or entered directly from the run-in or stabilization phase (paliperidone ER) of the earlier study. During the OLE, patients were treated with flexibly-dosed paliperidone ER (3–15 mg/day; 9 mg starting dose). Safety and tolerability assessments included incidence of adverse events and extrapyramidal symptoms. Efficacy was also assessed.

Results: The study population (n=235) was predominantly men (66%), 18–58 years of age. Twelve patients (5%) experienced an adverse event requiring treatment discontinuation. One or more serious treatment-emergent adverse events were reported in 13 patients (6%). There was one death. The mean Positive and Negative Syndrome Scale total score decreased from open-label baseline to endpoint for all groups, regardless of previous double-blind treatment (placebo or paliperidone ER).

Conclusion: This year-long OLE provides information on the long-term safety and tolerability of paliperidone ER in patients with schizophrenia. The resulting safety and tolerability profile was similar to that seen in earlier short-term studies.

Background: This study compared the 16-item Clinician and Self-Report versions of the Quick Inventory of Depressive Symptomatology (QIDS-C16 and QIDS-SR16) and the 10-item Montgomery-Asberg Depression Rating Scale (MADRS) in adult outpatients. The comparison was based on psychometric features and their performance in identifying those in a major depressive episode as defined by the Mini-International Neuropsychiatric Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.

Methods: Of 278 consecutive outpatients, 181 were depressed. Classical test theory, factor analysis, and item response theory were used to evaluate the psychometric features and receiver operating characteristic (ROC) analyses.

Results: All three measures were unidimensional. All had acceptable reliability (coefficient α=.87 for MADRS10, .82 for QIDS-C16, and .80 for QIDS-SR16). Test information function was higher for the MADRS (ie, it was most sensitive to individual differences in levels of depression). The MADRS and QIDS-C16 slightly but consistently outperformed the QIDS-SR16 in differentiating between depressed versus non-depressed patients.

Conclusion: All three measures have satisfactory psychometric properties and are valid screening tools for a major depressive episode.

Objective/Introduction: We sought to characterize the impact of the 90-item Symptom Checklist (SCL-90) subscales for paranoid ideation (PI) and psychoticism (P) in patients with major depressive disorder (MDD), on acute anti-depressant response and on relapse prevention.

Methods: Subjects with Structured Clinical Interview for DSM Disorders-diagnosed non-psychotic MDD were recruited into a clinical trial of open-label fluoxetine 10–60 mg/day for 12 weeks, followed by double-blind randomization of responders (n=262) to fluoxetine continuation or placebo for 12 months. PI and P were assessed with the patient-rated SCL-90. The association of these symptoms with response to treatment was assessed by logistic regression.

Results: We found significant decreases in PI and P during acute treatment phase for fluoxetine responders and nonresponders, although only 10.3% and 7.5% of patients experienced a ≥50% reduction in PI and P scores, respectively. Neither PI nor P scores significantly predicted time to relapse. P scores predicted a lower response rate to treatment with fluoxetine.

Discussion: The results of the present study suggest that there is a significant relationship between the presence of psychoticism in patients with nonpsychotic MDD, and the likelihood of overall depressive symptom improvement following a trial of monotherapy with fluoxetine.

Conclusion: An increased burden of psychoticism in depressed subjects may confer poorer response to fluoxetine, but not increased risk of relapse among fluoxetine responders.