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Journal articles on the topic 'Psychotic depression'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 February 2022

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1

Østergaard, S. D., P. T. Dinesen, G. Petrides, S. Skadhede, P. Munk-Jørgensen, and J. Nielsen. "Psychiatric morbidity preceding psychotic and non-psychotic depression." European Psychiatry 26, S2 (March 2011): 670. http://dx.doi.org/10.1016/s0924-9338(11)72376-8.

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IntroductionPsychotic depression differs significantly from non-psychotic depression in many aspects. These differences comprise etiology, severity, treatment response and prognosis.Objectives/aimsThe aim of the study was to assess the diversity of the psychiatric morbidity preceding psychotic and non-psychotic depression.MethodsDanish, register-based, nationwide cohort study. Subjects were all Danish residents assigned with an ICD-10 diagnosis of severe depression with- (F32.3 and F33.3) or without (F32.2 and F33.2) psychotic symptoms between January 1st 1994 and December 31st 2007. Psychiatric diagnoses preceding the severe depression were assessed through the Danish Psychiatric Central Research Register. It was investigated whether patients with psychotic depression had a history of more diverse/severe psychiatric morbidity and a different use of psychopharmacological drugs prior to index, compared to their non-psychotic counterparts.ResultsThe study included 29,254 subjects with severe depression. Of these, 9,768 patients (33%) were of the psychotic subtype while 19,576 (67%) were non-psychotic.Patients with the psychotic depressive subtype had a psychiatric history involving more and longer admission, more diverse diagnoses and a different pattern of psychopharmacological treatment compared to their non-psychotic counterparts. The results indicate, that psychotic depression may be more related to the bipolar/schizophrenia/psychosis spectrum than to the depression/anxiety spectrum.ConclusionsThe results add to a growing body of literature proving fundamental differences between psychotic- and non-psychotic severe depression. This should be considered in the upcoming revisions of the current diagnostic classifications.

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Kramer, I. M. A., C. J. P. Simons, I. Myin-Germeys, N. Jacobs, C. Derom, E. Thiery, J. van Os, and M. Wichers. "Evidence that genes for depression impact on the pathway from trauma to psychotic-like symptoms by occasioning emotional dysregulation." Psychological Medicine 42, no. 2 (August 11, 2011): 283–94. http://dx.doi.org/10.1017/s0033291711001474.

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BackgroundGenes for depression may act by making individuals more sensitive to childhood trauma. Given that childhood adversity is a risk factor for adult psychosis and symptoms of depression and psychosis tend to cluster within individuals and families, the aim was to examine whether the association between childhood adversity and psychotic-like symptoms is moderated by genetic liability for depression. A secondary aim was to determine to what degree a depression-related increase in stress sensitivity or depressive symptoms themselves occasioned the moderating effect.MethodFemale twins (n=508) completed both prospective and retrospective questionnaires regarding childhood adversity [the Symptom Checklist-90 – Revised (SCL-90-R) and SCID-I (psychotic symptoms)] and psychotic trait liability [the Community Assessment of Psychic Experiences (CAPE)]. Stress sensitivity was indexed by appraisals of event-related stress and negative affect (NA) in the flow of daily life, assessed with momentary assessment technology for five consecutive days. Multilevel regression analyses were used to examine moderation of childhood adversity by genetic liability for depression in the prediction of follow-up psychotic experiences.ResultsThe effect of childhood adversity was significantly moderated by genetic vulnerability for depression in the model of both follow-up psychotic experiences (SCL-90-R) and follow-up psychotic trait liability (CAPE). The moderation by genetic liability was mediated by depressive experience but not by stress sensitivity.ConclusionsGenetic liability for depression may potentiate the pathway from childhood adversity to psychotic-like symptoms through dysfunctional emotional processing of anomalous experiences associated with childhood trauma.

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Seemüller, F., M. Riedel, M. Obermeier, R. Schennach-Wolff, I. Spellmann, S. Meyer, M. Bauer, et al. "The validity of self-rated psychotic symptoms in depressed inpatients." European Psychiatry 27, no. 7 (October 2012): 547–52. http://dx.doi.org/10.1016/j.eurpsy.2011.01.004.

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AbstractBackgroundSelf-ratings of psychotic experiences might be biased by depressive symptoms.MethodData from a large naturalistic multicentre trial on depressed inpatients (n = 488) who were assessed on a biweekly basis until discharge were analyzed. Self-rated psychotic symptoms as assessed with the 90-Item Symptom Checklist (SCL-90) were correlated with the SCL-90 total score, the SCL-90 depression score, the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale 21 item (HAMD-21) total score, the Montgomery Åsberg Depression Rating Scale (MADRS) total score and the clinician-rated paranoid-hallucinatory score of the Association for Methodology and Documentation in Psychiatry (AMDP) scale.ResultsAt discharge the SCL-90 psychosis score correlated highest with the SCL-90 depression score (0.78, P<0.001) and with the BDI total score (0.64, P<0.001). Moderate correlations were found for the MADRS (0.34, P<0.001), HAMD (0.37, P<0.001) and AMDP depression score (0.33, P<0.001). Only a weak correlation was found between the SCL-90 psychosis score and the AMDP paranoid-hallucinatory syndrome score (0.15, P<0.001). Linear regression showed that change in self-rated psychotic symptoms over the treatment course was best explained by a change in the SCL-90 depression score (P<0.001). The change in clinician-rated AMDP paranoid-hallucinatory score had lesser influence (P = 0.02).ConclusionsIn depressed patients self-rated psychotic symptoms correlate poorly with clinician-rated psychotic symptoms. Caution is warranted when interpreting results from epidemiological surveys using self-rated psychotic symptom questionnaires as indicators of psychotic symptoms. Depressive symptoms which are highly prevalent in the general population might influence such self-ratings.

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4

Benazzi, Franco. "Psychotic Late-Life Depression: A 376-Case Study." International Psychogeriatrics 11, no. 3 (September 1999): 325–32. http://dx.doi.org/10.1017/s1041610299005888.

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The aim of the report was to study clinical differences between psychotic late-life depression and psychotic depression in younger patients, to determine if differences were age-related or specific for psychotic late-life depression. Three hundred seventy-six consecutive outpatients, presenting for treatment of unipolar or bipolar depression (with or without psychotic features), were assessed by means of the Structured Clinical Interview for DSM-IV, the Montgomery and Asberg Depression Rating Scale, and the Global Assessment of Functioning Scale. Results showed that psychotic late-life (50 years or more) depression, versus psychotic depression in younger patients, was associated with significantly higher age at study entry/onset, longer duration, and lower comorbidity. Psychotic depression versus nonpsychotic late-life depression, in late-life and in younger patients, was associated with significantly greater severity, lower comorbidity, more patients with bipolar I disorder, and fewer patients with unipolar disorder. Findings were related to psychosis or to age, and not to specific features of psychotic late-life depression. These results support a unitary view of psychotic depression.

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5

Birchwood, Max, Zaffer Iqbal, Paul Chadwick, and Peter Trower. "Cognitive approach to depression and suicidal thinking in psychosis." British Journal of Psychiatry 177, no. 6 (December 2000): 516–21. http://dx.doi.org/10.1192/bjp.177.6.516.

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BackgroundDepression in schizophrenia is a rather neglected field of study, perhaps because of its confused nosological status. Three course patterns of depression in schizophrenia, including post-psychotic depression (PPD), are proposed.AimsWe chart the ontogeny of depression and psychotic symptoms from the acute psychotic episode over a 12-month period and test the validity of the proposed course patterns.MethodOne hundred and five patients with ICD–10 schizophrenia were followed up on five occasions over 12 months following the acute episode, taking measures of depression, positive symptoms, negative symptoms, neuroleptic exposure and side-effects.ResultsDepression accompanied acute psychosis in 70% of cases and remitted in line with the psychosis; 36% developed PPD without a concomitant increase in psychotic symptoms.ConclusionsThe results provided support for the validity of two of the three course patterns of depression in schizophrenia, including PPD. Post-psychotic depression occurs de novo without concomitant change in positive or negative symptoms.

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6

Parker, G., D. Hadzi-Pavlovic, H. Brodaty, M. P. Austin, P. Mitchell, K. Wilhelm, and I. Hickie. "Sub-typing depression, II. Clinical distinction of psychotic depression and non-psychotic melancholia." Psychological Medicine 25, no. 4 (July 1995): 825–32. http://dx.doi.org/10.1017/s0033291700035078.

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SYNOPSISWe have attempted to clarify clinical differentiating features of psychotic depression. Forty-six depressed subjects meeting DSM-III-R criteria for major depression with psychotic features were compared with (i) DSM-defined melancholic, (ii) Newcastle-defined endogenous, and (iii) a residual DSM-defined major depressive episode group. Additionally, a ‘bottom up’ latent class analysis (LCA) suggested a larger sample of 82 ‘psychotic depressive’ subjects, and multivariate analyses contrasted these subjects with both LCA-identified melancholic and all residual depressed subjects. Analyses suggested that, in addition to two features with absolute specificity (delusions and hallucinations), both the DSM-defined and LCA-defined ‘psychotic depressive’ subjects were significantly more likely to demonstrate marked psychomotor disturbance, to report two morbid cognitions (feeling sinful and guilty; feeling deserving of punishment), as well as be more likely to report constipation, terminal insomnia, appetite/weight loss and (variable across the defined ‘psychotic depressive’ groups) loss of interest and pleasure. The study identifies a wider set of potentially discriminating clinical variables than previous studies, as well as both indicating the existence and assisting identification of ‘true’ psychotic depression in the absence of formal psychotic features being acknowledged or elicited.

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Sax, Kenji W., Stephen M. Strakowski, Paul E. Keck, Vidya H. Upadhyaya, Scott A. West, and Susan L. McElroy. "Relationships Among Negative, Positive, and Depressive Symptoms in Schizophrenia and Psychotic Depression." British Journal of Psychiatry 168, no. 1 (January 1996): 68–71. http://dx.doi.org/10.1192/bjp.168.1.68.

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BackgroundWe examined relationships among positive, negative, and depressive symptoms in schizophrenia and major depression with psychosis.MethodPatients with schizophrenia (n = 17) and major depression and psychotic features (n = 25), with no prior psychopharmacologic treatment were assessed on scales measuring positive psychotic, negative, and depressive symptoms.ResultsAnalyses revealed that depressive symptoms positively correlated with anhedonia/asociality and avolition/apathy in both patient groups. Positive psychotic symptoms significantly correlated with depressive symptoms in the schizophrenic group.ConclusionsSeveral specific symptoms used in defining both depressive and negative syndrome constructs appear to be shared. The relationship between positive symptoms and depression in schizophrenia and not psychotic depression suggests the severity of depression may be involved in this relationship.

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Adeosun, Increase Ibukun, and Oyetayo Jeje. "Symptom Profile and Severity in a Sample of Nigerians with Psychotic versus Nonpsychotic Major Depression." Depression Research and Treatment 2013 (2013): 1–6. http://dx.doi.org/10.1155/2013/815456.

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The therapeutic strategies in managing patients with psychotic major depression (PMD) differ from those with non-psychotic major depression (NMD), because of differences in clinical profile and outcome. However, there is underrecognition of psychotic symptoms in depressed patients. Previous studies in Western population suggest that certain symptom patterns, apart from psychosis which may be concealed, can facilitate the discrimination of PMD from NMD. These studies may have limited applicability to sub-Saharan Africa due to cross-cultural differences in the phenomenology of depression. This study compared the rates and severity of depressive symptoms in outpatients with PMD (n=129) and NMD (n=117) using the Structured Clinical Interview for Depression (SCID) and Hamilton Depression Rating Scale (HAM-D). Patients with PMD had statistically significantly higher rates of suicidal ideation, suicidal attempt, psychomotor agitation, insomnia, and reduced appetite. Patients with NMD were more likely to manifest psychomotor retardation and somatic symptoms. PMD was associated with greater symptom severity. On logistic regression analysis, suicidal ideation, psychomotor disturbances, insomnia, and somatic symptoms were predictive of diagnostic status. The presence of these symptoms clusters may increase the suspicion of occult psychosis in patients with depression, thereby informing appropriate intervention strategies.

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9

Nelson, Erik B., and Susan L. McElroy. "Psychotic Depression." CNS Drugs 8, no. 6 (December 1997): 457–73. http://dx.doi.org/10.2165/00023210-199708060-00004.

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10

Zdanowicz, Anna, and Piotr Wierzbiński. "Psychotic depression." Psychiatria i Psychologia Kliniczna 17, no. 2 (June 30, 2017): 115–19. http://dx.doi.org/10.15557/pipk.2017.0013.

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11

Clarke, Theresa, Uttam Wadhwa, and Iracema Leroi. "Psychotic Depression." Psychosomatics 39, no. 1 (January 1998): 72–75. http://dx.doi.org/10.1016/s0033-3182(98)71384-2.

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12

Wilcox, James Allen. "Psychotic Depression." Annals of Clinical Psychiatry 20, no. 2 (May 2008): 121. http://dx.doi.org/10.1080/10401230802017225.

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13

Lawrence, R., and S. M. Lawrie. "Psychotic depression." BMJ 345, oct24 2 (October 24, 2012): e6994-e6994. http://dx.doi.org/10.1136/bmj.e6994.

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Rothschild, Anthony J. "Treatment for Major Depression With Psychotic Features (Psychotic Depression)." FOCUS 14, no. 2 (April 2016): 207–9. http://dx.doi.org/10.1176/appi.focus.20150045.

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15

Østefjells, T., J. U. Lystad, A. O. Berg, R. Hagen, R. Loewy, L. Sandvik, I. Melle, and J. I. Røssberg. "Metacognitive beliefs mediate the effect of emotional abuse on depressive and psychotic symptoms in severe mental disorders." Psychological Medicine 47, no. 13 (April 11, 2017): 2323–33. http://dx.doi.org/10.1017/s0033291717000848.

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BackgroundEarly trauma is linked to higher symptom levels in bipolar and psychotic disorders, but the translating mechanisms are not well understood. This study examines whether the relationship between early emotional abuse and depressive symptoms is mediated by metacognitive beliefs about thoughts being uncontrollable/dangerous, and whether this pathway extends to influence positive symptoms.MethodPatients (N= 261) with psychotic or bipolar disorders were assessed for early trauma experiences, metacognitive beliefs, and current depression/anxiety and positive symptoms. Mediation path analyses using ordinary least-squares regressions tested if the effect of early emotional abuse on depression/anxiety was mediated by metacognitive beliefs, and if the effect of early emotional abuse on positive symptoms was mediated by metacognitive beliefs and depression/anxiety.ResultsMetacognitive beliefs about thoughts being uncontrollable/dangerous significantly mediated the relationship between early emotional abuse and depression/anxiety. Metacognitive beliefs and depression/anxiety significantly mediated the relationship between early emotional abuse and positive symptoms. The models explained a moderate amount of the variance in symptoms (R2= 0.21–0.29).ConclusionOur results indicate that early emotional abuse is relevant to depression/anxiety and positive symptoms in bipolar and psychotic disorders, and suggest that metacognitive beliefs could play a role in an affective pathway to psychosis. Metacognitive beliefs could be relevant treatment targets with regards to depression/anxiety and positive symptoms in bipolar and psychotic disorders.

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Omelchenko, M. A. "Clinical Features of Youth Depression with Attenuated Symptoms of the Schizophrenic Spectrum." Psikhiatriya 19, no. 1 (March 28, 2021): 16–25. http://dx.doi.org/10.30629/2618-6667-2021-19-1-16-25.

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Objective: establishment of clinical and psychometric features of youth depression with attenuated symptoms of the schizophrenic spectrum (ASSS) for early differential diagnosis and nosological assessment.Patients and methods: clinical and psychometric examination of young 219 inpatients (average age 19.6 ± 2.4 years), first admitted to the clinic “Mental Health Research Centre” from 2011 to 2020 with the first depressive episode with ASSS. Control group of inpatients (52 patients) with “classical” youth depressions without ASSS (average age 19.6 ± 2.4 years). Diagnosis according ICD-10: F32.1, F32.2, F32.28, F32.8.Results: the psychopathological structure of youth depression with ASSS is characterized by the following types: (1) depression with attenuated psychotic symptoms (APS), which were divided into the subtype (1a) depression with APS and (1b) depression with brief limited intermittent psychotic symptoms (BLIPS); (2) depression with attenuated negative symptoms (ANS), comprising two subtypes (2a) with most emotional damage and (2b) with volitional impairment, and type (3) with attenuated symptoms of disorganization (ASD) in the structure of depressive episode. Clinical and reliable psychometric differences have been established between depressions with ASSS and «classical» youth depressions without ASSS. Conclusions: youth depression with ASSS is definitely different from “classical” youth depression without ASSS. Differences have been found in the psychopathological structure of youth depression with ASSS, resulting in a typological differentiation.

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Dassa, Daniel, Arthur Kaladjian, Jean M. Azorin, and Sebastien Giudicelli. "Clozapine in the Treatment of Psychotic Refractory Depression." British Journal of Psychiatry 163, no. 6 (December 1993): 822–24. http://dx.doi.org/10.1192/bjp.163.6.822.

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A 40-year-old woman suffering from major depression with psychotic features was unresponsive to conventional therapy. After the administration of a wide range of drug treatments and ECT, she received clozapine. Depressive symptoms improved and psychotic features disappeared. It is suggested that clozapine could be efficient in psychotic refractory depression.

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Marks, M. N., A. Wieck, S. A. Checkley, and R. Kumar. "Life Stress and Post-Partum Psychosis: a Preliminary Report." British Journal of Psychiatry 158, S10 (May 1991): 45–49. http://dx.doi.org/10.1192/s0007125000291988.

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This is a preliminary report from a prospective study of the influence of psychosocial stressors on post-natal relapse in women at high risk of psychiatric disorder after childbirth. Forty-three index subjects with a previous history of psychosis or severe depression were compared with 45 pregnant control subjects without any previous psychiatric disorder. After delivery 51% of index subjects relapsed (RDC diagnoses): 28% were categorised as psychotic and 23% non-psychotic. All psychotic relapses were in women with a previous history of bipolar or schizoaffective disorder (46% of this subgroup). Only the non-psychotic post-partum relapses (mostly depressions) were associated with an increased likelihood of a severe life event in the 12 months preceding illness onset.

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Elsawy, H. F., M. A. Abd Elhay, and A. B. Abd Elkrem. "FC07-01 - Cognitive functions in first episode psychosis." European Psychiatry 26, S2 (March 2011): 1846. http://dx.doi.org/10.1016/s0924-9338(11)73550-7.

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BackgroundCognitive impairment is recognized as an important feature of psychosis in its early stages and is a determinant of prognosis and management of these disorders.Aim of the studyTo test the cognitive functions in first psychotic episode in patients with disorders of schizophrenia, schizoaffective disorder, bipolar disorder and depression with psychotic disorder and to compare them to controls.Subjects and methodsThe study included 254 patients diagnosed according to Diagnostic and Statistical criteria of Mental disorders, 4th edition (91 schizophrenics, 21 with schizoaffective disorder, 107 with bipolar disorder and 31 with psychotic depression) and experiencing their first psychotic episode. Seventy healthy volunteers matched as regards age and sex with patients were used as controls. All are subjected to cognitive evaluation by Trail Making Test, part B, Wisconsin card sorting test 128, Benton Visual Retention Test and Wechsler Adult Intelligence Test.ResultsAll patients showed significant cognitive deterioration in all tests compared to control group. On comparing patients to each other, there was no significant difference between schizophrenics and patients with bipolar disorder, but both showed marked deterioration in comparison to depressive group.ConclusionCognitive impairments are present in early stages of psychosis and need careful assessment and management.

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Tyrka, Audrey R., Lawrence H. Price, Marcelo F. Mello, Andrea F. Mello, and Linda L. Carpenter. "Psychotic Major Depression." Drug Safety 29, no. 6 (2006): 491–508. http://dx.doi.org/10.2165/00002018-200629060-00003.

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Østergaard, S. D., B. S. Meyers, A. J. Flint, B. H. Mulsant, E. M. Whyte, C. M. Ulbricht, P. Bech, and A. J. Rothschild. "Measuring psychotic depression." Acta Psychiatrica Scandinavica 129, no. 3 (June 25, 2013): 211–20. http://dx.doi.org/10.1111/acps.12165.

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Lindley, Steven E., Eve Carlson, and Javaid Sheikh. "Psychotic Symptoms in Posttraumatic Stress Disorder." CNS Spectrums 5, no. 9 (September 2000): 52–57. http://dx.doi.org/10.1017/s1092852900021659.

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AbstractRecent data suggest that the presence of psychotic symptoms in patients suffering from posttraumatic stress disorder (PTSD) may represent an underrecognized and unique subtype of PTSD. Among combat veterans with PTSD, 30% to 40% report auditory or visual hallucinations and/or delusions. The presence of psychotic symptoms in PTSD is associated with a more severe level of psychopathology, similar to that of chronic schizophrenia. In this review, the differential diagnosis of psychotic symptoms in PTSD is discussed, including possible comorbid schizophrenia, psychotic depression, substance-induced psychosis, and personality disorder. A recent biologic study supporting the existence of a unique subtype of PTSD with psychotic features is also addressed, as are the similarities between PTSD with psychotic features and psychotic depression disorder. Finally, data on the treatment implications of psychotic symptoms in PTSD are presented. The intriguing recent findings on psychotic symptoms in PTSD need further investigation in noncombat-related PTSD populations before findings can be generalized to all individuals with PTSD.

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Bingham, Kathleen S., Benoit H. Mulsant, Deirdre R. Dawson, Samprit Banerjee, and Alastair J. Flint. "Relationship of Hair Cortisol with History of Psychosis, Neuropsychological Performance and Functioning in Remitted Later-Life Major Depression." Neuropsychobiology 80, no. 4 (2021): 313–20. http://dx.doi.org/10.1159/000512081.

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<b><i>Introduction:</i></b> Major depressive disorder (MDD) is associated with hypothalamic-pituitary-adrenal axis dysfunction that may persist into remission. Preliminary evidence suggests that this dysfunction may be associated with impaired neuropsychological performance in remitted MDD. MDD with psychotic features (“psychotic depression”) is associated with greater neuropsychological and functional impairment than nonpsychotic depression, including in remission. Therefore, the aim of this exploratory study was to examine the relationships among hair cortisol concentration (HCC) – a marker of longer term endogenous cortisol exposure – and history of psychotic features, neuropsychological performance, and functioning in remitted MDD. <b><i>Methods:</i></b> This cross-sectional study compared the relationship between HCC and (i) history of psychosis, (ii) neuropsychological performance, and (iii) everyday functioning in a group of 60 participants with remitted later-life MDD using Pearson’s correlation coefficients. This study also measured HCC in a group of 36 nonpsychiatric volunteers to examine the clinical significance of HCC in the patient group. <b><i>Results:</i></b> There were no statistically significant correlations between HCC and history of psychotic features, neuropsychological performance, or functioning. Furthermore, there was no clinically meaningful difference in HCC between patients and nonpsychiatric volunteers. <b><i>Conclusion:</i></b> This study is the first to examine HCC in psychotic depression. The results do not support the hypothesis that impaired neuropsychological performance, and everyday function in remitted psychotic depression is due to a sustained elevation of cortisol.

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24

Christie, Janice E., Lawrence J. Whalley, Heinz Dick, Douglas M. R. Blackwood, Ivy M. Blackburn, and George Fink. "Raised Plasma Cortisol Concentrations a Feature of Drug-Free Psychotics and not Specific for Depression." British Journal of Psychiatry 148, no. 1 (January 1986): 58–65. http://dx.doi.org/10.1192/bjp.148.1.58.

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To determine whether high plasma cortisol concentrations are a distinctive feature of depression or whether plasma cortisol is also elevated in other forms of psychosis, cortisol concentrations were measured in 59 patients with acute functional psychoses, six non-psychotic depressed patients and 37 control subjects, all free of antidepressant and neuroleptic drugs for at least three months. Patients with schizoaffective disorder, manic type, had the highest concentrations throughout the day and those with major depressive disorder, psychotic sub-type had higher concentrations than controls in the afternoon and evening. Manic and schizophrenic patients had cortisol concentrations above controls in the afternoon only. Elevated concentrations were not related to the presence of depressed mood or to duration of stay in hospital, and a return to normal occurred irrespective of the type of treatment used. Thus raised plasma cortisol concentrations are a feature of psychotic illness, but in drug-free patients are not specific for severe depression.

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Aylott, A., A. Zwicker, L. E. MacKenzie, J. Cumby, L. Propper, S. Abidi, A. Bagnell, et al. "Like father like daughter: sex-specific parent-of-origin effects in the transmission of liability for psychotic symptoms to offspring." Journal of Developmental Origins of Health and Disease 10, no. 1 (August 29, 2018): 100–107. http://dx.doi.org/10.1017/s2040174418000612.

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AbstractChildren of parents with major mood and psychotic disorders are at increased risk of psychopathology, including psychotic symptoms. It has been suggested that the risk of psychosis may be more often transmitted from parent to opposite-sex offspring (e.g., from father to daughter) than to same-sex offspring (e.g., from father to son). To test whether sex-specific transmission extends to early manifestations of psychosis, we examined sex-specific contributions to psychotic symptoms among offspring of mothers and fathers with depression, bipolar disorder and schizophrenia. We assessed psychotic symptoms in 309 offspring (160 daughters and 149 sons) aged 8–24 years (mean=13.1, s.d.=4.3), of whom 113 had a mother with schizophrenia, bipolar disorder or major depression and 43 had a father with schizophrenia, bipolar disorder or major depression. In semi-structured interviews, 130 (42%) offspring had definite psychotic symptoms established and confirmed by psychiatrists on one or more assessments. We tested the effects of mental illness in parents on same-sex and opposite-sex offspring psychotic symptoms in mixed-effect logistic regression models. Psychotic symptoms were more prevalent among daughters of affected fathers and sons of affected mothers than among offspring of the same sex as their affected parent. Mental illness in the opposite-sex parent increased the odds of psychotic symptoms (odds ratio (OR)=2.65, 95% confidence interval (CI) 1.43–4.91, P=0.002), but mental illness in the same-sex parent did not have a significant effect on psychotic symptoms in offspring (OR=1.13, 95% CI 0.61–2.07, P=0.697). The opposite-sex-specific parent-of-origin effects may suggest X chromosome-linked genetic transmission or inherited chromosomal modifications in the etiology of psychotic symptoms.

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Østergaard, Søren D., Barnett S. Meyers, Alastair J. Flint, Benoit H. Mulsant, Ellen M. Whyte, Christine M. Ulbricht, Per Bech, and Anthony J. Rothschild. "Measuring treatment response in psychotic depression: The Psychotic Depression Assessment Scale (PDAS) takes both depressive and psychotic symptoms into account." Journal of Affective Disorders 160 (May 2014): 68–73. http://dx.doi.org/10.1016/j.jad.2013.12.020.

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Schoevers, R. A., M. I. Geerlings, A. T. F. Beekman, B. W. J. H. Penninx, D. J. H. Deeg, C. Jonker, and W. Van Tilburg. "Association of depression and gender with mortality in old age." British Journal of Psychiatry 177, no. 4 (October 2000): 336–42. http://dx.doi.org/10.1192/bjp.177.4.336.

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BackgroundThe association between depression and increased mortality risk in older persons may depend on the severity of the depressive disorder and gender.AimsTo investigate the association between major and mild depressive syndromes and excess mortality in community-living elderly men and women.MethodDepression (Geriatric Mental State AGECAT) was assessed in 4051 older persons, with a 6-year follow-up of community death registers. The mortality risk of neurotic and psychotic depression was calculated after adjustment for demographic variables, physical illness, cognitive decline and functional disabilities.ResultsA total of 75% of men and 41% of women with psychotic depression had died at follow-up. Psychotic depression was associated with significant excess mortality in both men and women. Neurotic depression was associated with a 1.67-fold higher mortality risk in men only.ConclusionsIn the elderly, major depressive syndromes increase the risk of death in both men and women, but mild depression increases the risk of death only in men.

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Pull, C. B., M. C. Pull, and P. Pichot. "French diagnostic criteria for depression." Psychiatry and Psychobiology 3, no. 5 (1988): 321–28. http://dx.doi.org/10.1017/s0767399x00002455.

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SummaryThe traditional French nosology of mood disorders is based upon the classical endogenous vs psychogenic dichotomy. The French Classification of Mental Disorders, established by the National Institute of Health and Medical Research (Institut National de la Santé et de la Recherche Médicale or INSERM) refers, however, to a different terminology: psychotic is used instead of endogenous and non-psychotic instead of psychogenic.The present report is an attempt to provide operational definitions for the major categories of depression in French nosology. It is based upon an empirical investigation. Fifty French clinicians selected 5 cases among patients who had been diagnosed as presenting either a psychotic depression, a non-psychotic depression or a schizophrenia with mood disorder. For each patient, the participants evaluated the presence or absence of 100 criteria presented in a list, the List of Integrated Criteria for the Evaluation of Taxonomy in Depressive Disorders (LICET-D 100). The list assembles all diagnostic criteria which have been proposed for a diagnosis of depression in 7 recent classification systems.The data were analyzed in 2 steps. The aim of the first step was to define a basic depressive syndrome, termed “unspecific depressive syndrome”, present in all the depressive disorders, independently of their subtypes. The aim of the second step was to elicit a diagnostic index for distinguishing between psychotic and non-psychotic depression. The operational definitions presented in this report are “empirical” in as much as they have been derived from the evaluation of actual patients. They are “French” in as much as they are based upon data obtained from a representative sample of French psychiatrists. They have a high face validity in that they correspond to and in fact simply translate French diagnostic practices in this field. They finally have a satisfactory discriminative validity in that they “correctly” reclassify 82% of the patients, i.e. achieve agreement with clinical diagnosis in more than 8 cases ont of 10.The present report does not provide and in fact was not designed to elicit information on the predictive or construct validities of French diagnostic practices in the field of depressive disorders.

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Lazarescu, M. "the Long Term Evolution of Periodical Affective Disorders, with and without Psychotic Symptoms." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)71401-4.

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In the Psychiatric Clinic in Timisoara, we began a study of the long term evolution (over 10 years) on two comparative groups of patients with affective disorders, with and without incongruent psychotic symptoms. We compared one group of 20 bipolar patients with psychotic symptoms with another group of 20 bipolars without psychotic symptoms. the same was done with two groups of 20 patients with monopolar depression. We did not include the cases with more than one schizoaffective episode, which were studied separately. We came to the conclusion that affective disorders associated with incongruent psychosis, had an earlier onset, a worse prognosis and other genetic and temperamental characteristics, than the ones without psychotic symptoms. Also the cases with schizoaffective disorder (schizo-bipolar and schizo-depressive) we have studied had an earlier onset and a bad prognosis.

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Wragg, Jillian A., and Ruth E. Whitehead. "CBT FOR ADOLESCENTS WITH PSYCHOSIS: INVESTIGATING THE FEASIBILITY AND EFFECTIVENESS OF EARLY INTERVENTION USING A SINGLE CASE DESIGN." Behavioural and Cognitive Psychotherapy 32, no. 3 (June 14, 2004): 313–29. http://dx.doi.org/10.1017/s1352465804001389.

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This paper presents a single case study investigating the use of cognitive behavioural therapy (CBT) with an adolescent experiencing a psychotic episode. The participant was a 15-year-old girl with first episode psychosis, who was an inpatient in an adolescent psychiatric unit. Progress was evaluated using an AB time series design, lasting 16 weeks in total. After a baseline assessment (A) the participant received a 16-week CBT intervention for psychosis (B). The effectiveness of the intervention was investigated with relation to psychotic symptoms, self-esteem, recovery style, person evaluations, anxiety and depression. The results indicated that there were some improvements in symptoms of anxiety, depression and psychosis but were inconclusive for the other measures. It is argued that the maintenance of negative person evaluations had a detrimental effect on the participant's ability to increase self-esteem, change recovery style and further reduce psychotic symptoms, anxiety and depression. The impact of environmental factors on the progression of the participant's illness is considered and the findings are discussed in relation to previous literature.

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Hernández Sánchez, J. M., M. Á. Canseco Navarro, M. Machado Vera, C. Garay Bravo, and D. Peña Serrano. "Late Onset Psychosis. Review." European Psychiatry 33, S1 (March 2016): S530. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1962.

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IntroductionSeveral risk factors make older adults more prone to psychosis. The persistent growth in the elderly population makes important the necessity of accurate diagnosis of psychosis, since this population has special features especially regarding to the pharmacotherapy and side effects.ObjectivesTo review the medical literature related to late-life psychosis.MethodsMedline search and ulterior review of the related literature.ResultsReinhard et al. [1] highlight the fact that up to 60% of patients with late onset psychosis have a secondary psychosis, including: metabolic (electrolite abnormalities, vitamines defficiency…); infections (meningitides, encephalitides…); neurological (dementia, epilepsy…); endocrine (hypoglycemia…); and intoxication. Colijn et al. [2] describe the epidemiological and clinical features of the following disorders: schizophrenia (0.3% lifetime prevalence > 65 years); delusional disorder (0.18% lifetime prevalence); psychotic depression (0.35% lifetime prevalence); schizoaffective disorder (0.32% lifetime prevalence); Alzheimer disease (41.1% prevalence of psychotic symptoms); Parkinson's disease (43% prevalence of psychotic symptoms); Parkinson's disease dementia (89% prevalence of visual hallucinations); Lewy body dementia (up to 78% prevalence of hallucinations) and vascular dementia (variable estimates of psychotic symptoms). Recommendations for treatment include risperidone, olanzapine, quetiapine, aripiprazole, clozapine, donepezil and rivastigmine.ConclusionsDifferential diagnosis is tremendously important in elderly people, as late-life psychosis can be a manifestation of organic disturbances. Mental disorders such as schizophrenia or psychotic depression may have different manifestations in comparison with early onset psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Bjørklund, Louise B., Henriette T. Horsdal, Ole Mors, Christiane Gasse, and Søren D. Østergaard. "Psychopharmacological treatment of psychotic mania and psychotic bipolar depression compared to non-psychotic mania and non-psychotic bipolar depression." Bipolar Disorders 19, no. 6 (June 8, 2017): 505–12. http://dx.doi.org/10.1111/bdi.12504.

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Walton, Catherine, and Mike Kerr. "Prader Willi syndrome: systematic review of the prevalence and nature of presentation of unipolar depression." Advances in Mental Health and Intellectual Disabilities 10, no. 3 (May 3, 2016): 172–84. http://dx.doi.org/10.1108/amhid-08-2015-0037.

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Purpose – The purpose of this paper is to assess the prevalence and nature of presentation of unipolar depression in individuals with Prader-Willi syndrome (PWS). Design/methodology/approach – The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (2009) checklist for systematic reviews was followed where possible. Findings – Seven studies were included in the qualitative synthesis from a total of 261 records identified. The quality of the studies was then assessed: scores for each study design ranged from between 3 and 6 of a possible score total of 6. The frequency of depression ranged between studies from 4 to 22 per cent. four studies showed over 50 per cent of patients appeared to suffer from psychotic symptoms. Low mood, anhedonia and irritability were described as features of depression, although no fixed pattern of psychopathology arose from across the studies (excluding psychosis). This review has provided evidence to suggest that depression is a frequent occurrence in the PWS population. One study found that the incidence of depression differed between the genetic subtypes, raising questions regarding the relationship between genotype and behavioural phenotypes. A high proportion of individuals with depression suffered from psychotic symptoms. Research limitations/implications – The small number of heterogeneous studies included in this study precluded meta-analysis of the results. This highlights the need for further original research in this field. Practical implications – An increased awareness of the frequency of depressive symptoms within the PWS population will aid in the timely diagnosis and management of the disorder which will reduce psychiatric morbidity. The noted high proportion of psychotic symptoms associated with depression should raise the index of suspicion with clinicians and aid appropriate management decisions. Originality/value – This review has provided preliminary evidence for the nature of presentation of unipolar depression in PWS. It has highlighted the possibility of an increased propensity towards depression with psychotic symptoms. There is some suggestion of a differing presentation and course of unipolar depression between the common genetic subtypes of PWS which warrants further investigation.

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Draper, Brian, and Kaarin Anstey. "Psychosocial Stressors, Physical Illness and the Spectrum of Depression in Elderly Inpatients." Australian & New Zealand Journal of Psychiatry 30, no. 5 (October 1996): 567–72. http://dx.doi.org/10.3109/00048679609062651.

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Objectives: To describe all elderly patients hospitalised with principal and secondary diagnoses of depression, and to determine whether a relationship can be demonstrated between psychosocial stressors, physical illness and type of depression. Method: A retrospective chart review of elderly patients admitted to a general hospital psychiatry ward over a 7-year period with principal or secondary diagnoses of depression was undertaken. Four broad diagnostic categories of depression were used: major depression, psychotic depression, minor depression, and organic depression. Chief outcome measures were: number of medical diagnostic categories, presence of psychosocial stressors, global clinical improvement, and length of stay. Results: Of 228 patients admitted with depression (194 principal diagnoses and 34 secondary diagnoses), 100 had major depression, 47 psychotic depression, 48 minor depression and 33 organic depression. Psychiatric comorbidi-ty occurred in 70%, about half of which was due to organic brain syndrome. Patients with psychotic depression had the fewest medical problems and those with organic depression the most, while patients with minor depression had the highest rate of family and marital problems, comorbid personality dysfunction and suicide attempts. Patients with psychotic depression had the longest admissions, while those with minor depression had the shortest. Overall, 89% showed significant clinical improvement. Conclusions: Elderly inpatients have a wide spectrum of depressive disorders with different psychosocial, medical and treatment profiles. Future studies of depression in old age should include all patients with clinical depression.

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McDonnell, Tara Muire, Michael Lockhart, Carmel Kennedy, Leanne Cussen, Graham Roberts, Diarmuid Smith, Mohsen Javadpour, and Amar Agha. "Cushing’s Disease Presenting With Severe Weight Loss, Anorexia and Refractory Psychotic Depression." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A580. http://dx.doi.org/10.1210/jendso/bvab048.1183.

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Abstract Introduction: In this paper we report an unusual case of Cushing’s disease presenting with psychotic depression, paranoia, anorexia leading to severe weight loss culminating in 18% of her body weight. Case: A 22 year old female admitted with first episode psychosis to her local hospital displaying psychotic depressive symptoms, low mood, severe anorexia and mood congruent delusions regarding food contamination. Clinical manifestations of Cushing’s were recognised: cushingoid facies, facial plethora, hirsutism with striae and proximal myopathy. The degree of weight loss (70kg to 57kg) and paranoid ideation surrounding food necessitated caloric supplementation parenterally. Laboratory indices notable for hypokalaemia of 2.7nmol/l, male range testosterone level of 10.7nmol/l, DHEAS>27.1umol and suppressed gonadotrophins. Urine Free Cortisol was >25 times normal. Late night salivary cortisol was 13.4nmol/L(<2.6nmol/L). ACTH was raised at 74.0pg/ml in keeping ACTH dependent Cushing’s. MRI pituitary showed a bulky pituitary. CRF testing and Inferior Petrosal Sinus Sampling both indicated pituitary dependent Cushing’s disease. Following Metyrapone therapy and nutritional treatment the patient condition improved. She proceeded to transphenoidal pituitary exploration. Intraoperatively a very soft central lesion was excised and neuropathology confirmed a corticotroph adenoma. Post-operative morning cortisol at day 3 was 31nmol/l indicating early remission. 3 months post-operative there was remarkable improvement in mood, weight, cessation of anti-psychotics with normal diet and return of menses. She remained severely hypocortisolaemic 6 months post-op Conclusion: Cushing’s disease may present with severe psychiatric manifestation and significant weight loss. Clinicians need to be vigilant of psychosis as the primary presentation of Cushing’s disease.

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Wahlund, Björn, Paolo Piazza, Dietrich von Rosen, Benny Liberg, and Hans Liljenström. "Seizure (Ictal)—EEG Characteristics in Subgroups of Depressive Disorder in Patients Receiving Electroconvulsive Therapy (ECT)—A Preliminary Study and Multivariate Approach." Computational Intelligence and Neuroscience 2009 (2009): 1–8. http://dx.doi.org/10.1155/2009/965209.

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Objectives. Examine frequency distributions of ictal EEG after ECT stimulation in diagnostic subgroups of depression.Methods. EEG registration was consecutively monitored in 33 patients after ECT stimulation. Patients were diagnosed according to DSM IV and subdivided into: (1) major depressive disorder with psychotic features(n=7), (2) unipolar depression(n=20), and (3) bipolar depression(n=6).Results. Results indicate that the diagnostically subgroups differ in their ictal EEG frequency spectrumml: (1) psychotic depression has a high occurrence of delta and theta waves, (2) unipolar depression has high occurrence of delta, theta and gamma waves, and (3) bipolar depression has a high occurrence of gamma waves. A linear discriminant function separated the three clinical groups with an accuracy of 94%.Conclusion. Psychotic depressed patients differ from bipolar depression in their frequency based on probability distribution of ictal EEG. Psychotic depressed patients show more prominent slowing of EEG than nonpsychotic depressed patients. Thus the EEG results may be supportive in classifying subgroups of depression already at the start of the ECT treatment.

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Gewirtz, George, Elizabeth Squires-Wheeler, Zafar Sharif, and William G. Honer. "Results of Computerised Tomography During First Admission for Psychosis." British Journal of Psychiatry 164, no. 6 (June 1994): 789–95. http://dx.doi.org/10.1192/bjp.164.6.789.

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A cohort of 168 psychotic patients underwent computerised tomography (CT) during their first admission. Cortical atrophy was present in 40% of patients. The frequency of atrophy increased with age, but did not differ between patients with schizophrenia, schizoaffective disorder, bipolar disorder or psychotic depression. Other CT findings of note were present in 6.6% of patients, and included four infarctions, three arachnoid cysts, and one each of venous angioma, colloid cyst, cavum vergae and post-traumatic changes. The frequency of CT findings other than atrophy was increased in the psychotic depression group. The findings support the proposal of the onset of psychosis being an indication for CT.

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38

Jobson, Kenneth, and Charles DeBattista. "Treatment of Psychotic Depression." Psychiatric Annals 32, no. 11 (November 1, 2002): 654. http://dx.doi.org/10.3928/0048-5713-20021101-04.

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Swartz, Conrad M. "Psychotic Depression or Schizophrenia." Psychiatric Annals 40, no. 2 (February 1, 2010): 92–97. http://dx.doi.org/10.3928/00485718-20100127-05.

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Howland, Robert H. "Pharmacotherapy for Psychotic Depression." Journal of Psychosocial Nursing and Mental Health Services 44, no. 12 (December 1, 2006): 13–17. http://dx.doi.org/10.3928/02793695-20061201-08.

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41

Ayd, Frank J. "PHARMACOTHERAPY FOR PSYCHOTIC DEPRESSION." Psychiatric Annals 15, no. 8 (August 1, 1985): 506—C3. http://dx.doi.org/10.3928/0048-5713-19850801-15.

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42

Coryell, William, and John T. Moranville. "Alprazolam for psychotic depression." Biological Psychiatry 25, no. 3 (February 1989): 367–69. http://dx.doi.org/10.1016/0006-3223(89)90188-1.

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43

Mol, Brigitte, Janet Odani, and Mahendra Perera. "Erotomania and psychotic depression." Australian & New Zealand Journal of Psychiatry 49, no. 11 (August 10, 2015): 1069–70. http://dx.doi.org/10.1177/0004867415597306.

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BLACK, DONALD W. "Suicide and Psychotic Depression." American Journal of Psychiatry 161, no. 4 (April 2004): 765. http://dx.doi.org/10.1176/appi.ajp.161.4.765.

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45

Debattista, Charles, Brent Solvason, Joseph Belanoff, and Alan F. Schatzberg. "Treatment of Psychotic Depression." American Journal of Psychiatry 154, no. 11 (November 1997): 1625–26. http://dx.doi.org/10.1176/ajp.154.11.1625.

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Ng, Bradley K. W. "Methylphenidate and Psychotic Depression." Clinical Neuropharmacology 32, no. 3 (May 2009): 177. http://dx.doi.org/10.1097/wnf.0b013e3181911a9c.

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Vythilingam, Meena, Joyce Chen, J. Douglas Bremner, Carolyn M. Mazure, Paul K. Maciejewski, and J. Craig Nelson. "Psychotic Depression and Mortality." American Journal of Psychiatry 160, no. 3 (March 2003): 574–76. http://dx.doi.org/10.1176/appi.ajp.160.3.574.

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Mazzoli, Marco, and Franco Benazzi. "Polycythaemia and psychotic depression." British Journal of Psychiatry 160, no. 1 (January 1992): 134–35. http://dx.doi.org/10.1192/bjp.160.1.134b.

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ROTHSCHILD, ANTHONY J. "On Psychotic Major Depression." American Journal of Psychiatry 153, no. 6 (June 1996): 847. http://dx.doi.org/10.1176/ajp.153.6.847.

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Rothschild, Anthony J. "Psychotic depression and suicide." Acta Psychiatrica Scandinavica 137, no. 4 (March 9, 2018): 364–65. http://dx.doi.org/10.1111/acps.12864.

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