The deficit syndrome in the DSM-IV field trial .2. Depressive episodes and persecutory beliefs

Patients with the deficit syndrome are remarkable for their decrease in interest in social relationships, suggesting they have an abnormality in those brain regions controlling social behavior and social cognition. To further assess social behavior and social cognition in this group of patients, we examined the relationships among three aspects of the psychopathology: suspiciousness; major depressive episodes; and the deficit syndrome. These features of psychopathology were examined in two clinical samples: stable outpatients from a research clinic (the MPRC sample), and patients in the DSM-IV Field Trial. In both samples, patients with history of a depressive episode had more severe suspiciousness than those without such a history; other psychotic symptoms were not associated with depressive episodes. In the MPRC sample, patients with the deficit syndrome exhibited less severe suspiciousness than nondeficit patients; in the Field Trial sample, this same comparison had a nonsignificant trend in the same direction. In the Field Trial sample, patients with the deficit syndrome also had less severe delusions with a predominantly social content than did nondeficit patients. These findings suggest suspiciousness is a risk factor for major depression in schizophrenia, and that the decreased interests in social relationships exhibited by deficit syndrome patients is reflected in the content of their delusions.