M Zimmerman1, J I Mattia. 1. Department of Psychiatry and Human Behavior, Brown University School of Medicine, Rhode Island Hospital, Providence 02905, USA. MZimmerman@lifespan.org
Abstract
BACKGROUND: Many studies have established that a large percentage of patients with posttraumatic stress disorder (PTSD) have comorbid major depressive disorder. Other studies have found that patients with PTSD or a history of childhood trauma have an increased rate of psychotic symptoms. In the present report from the Rhode Island Methods to Improve Diagnosis and Services project, we examine whether an association exists between psychotic subtyping of major depressive disorder and PTSD. METHOD: Five hundred psychiatric outpatients were interviewed with the Structured Clinical Interview for DSM-IV. RESULTS: Almost half of the 500 patients had nonbipolar major depressive disorder (N = 235, 47.0%), 45 (19.1%) of whom had PTSD. Nineteen patients had psychotic depression, 216 had nonpsychotic depression. Compared with patients with nonpsychotic depression, the patients with psychotic depression were nearly 4 times more likely to have PTSD (57.9% vs. 15.7%, Fisher exact test, p = .0001). CONCLUSION: The results of the present study suggest that the presence of psychosis in psychiatric outpatients with major depressive disorder is associated with concurrent PTSD. It is hypothesized that the poorer longitudinal course of psychotic versus nonpsychotic depression may be due to the underrecognition of PTSD in psychotically depressed patients.
BACKGROUND: Many studies have established that a large percentage of patients with posttraumatic stress disorder (PTSD) have comorbid major depressive disorder. Other studies have found that patients with PTSD or a history of childhood trauma have an increased rate of psychotic symptoms. In the present report from the Rhode Island Methods to Improve Diagnosis and Services project, we examine whether an association exists between psychotic subtyping of major depressive disorder and PTSD. METHOD: Five hundred psychiatric outpatients were interviewed with the Structured Clinical Interview for DSM-IV. RESULTS: Almost half of the 500 patients had nonbipolar major depressive disorder (N = 235, 47.0%), 45 (19.1%) of whom had PTSD. Nineteen patients had psychotic depression, 216 had nonpsychotic depression. Compared with patients with nonpsychotic depression, the patients with psychotic depression were nearly 4 times more likely to have PTSD (57.9% vs. 15.7%, Fisher exact test, p = .0001). CONCLUSION: The results of the present study suggest that the presence of psychosis in psychiatric outpatients with major depressive disorder is associated with concurrent PTSD. It is hypothesized that the poorer longitudinal course of psychotic versus nonpsychotic depression may be due to the underrecognition of PTSD in psychotically depressedpatients.
Authors: A Carlo Altamura; Marta Serati; Alessandra Albano; Riccardo A Paoli; Ira D Glick; Bernardo Dell'Osso Journal: Eur Arch Psychiatry Clin Neurosci Date: 2011-02-18 Impact factor: 5.270
Authors: Jennifer D Gottlieb; Kim T Mueser; Stanley D Rosenberg; Haiyi Xie; Rosemarie S Wolfe Journal: Compr Psychiatry Date: 2010-07-02 Impact factor: 3.735