BACKGROUND: Psychotic depression (PD) is classified as a subtype of severe depression in the current diagnostic manuals. Accordingly, it is a common conception among psychiatrists that psychotic features in depression arise as a consequence of depressive severity. The aim of this study was to determine whether the severity of depressive and psychotic symptoms correlate in accordance with this "severity-psychosis" hypothesis and to detect potential differences in the clinical features of PD and non-psychotic depression (non-PD). METHODS: Quantitative analysis of Health of the Nation Outcome Scales (HoNOS) scores from all patients admitted to a Danish general psychiatric hospital due to a severe depressive episode in the period between 2000 and 2010 was performed. RESULTS: A total of 357 patients with severe depression, of which 125 (35%) were of the psychotic subtype, formed the study sample. Mean HoNOS scores at admission differed significantly between patients with non-PD and PD on the items hallucinations and delusions (non-PD=0.33 vs. PD=1.37, p<0.001), aggression (non-PD=0.20 vs. PD=0.36, p=0.044) and on the total score (non-PD=10.55 vs. PD=11.87, p=0.024). The HoNOS scores on the two items "depression" and "hallucinations and delusions" were very weakly correlated. LIMITATIONS: Diagnoses were based on normal clinical practice and not formalized research criteria. CONCLUSIONS: The symptomatology of PD and non-PD differs beyond the mere psychosis. Furthermore, severity ratings of depressive and psychotic symptoms are very weakly correlated. These findings offer further support to the hypothesis stating that the psychotic- and non-psychotic subtypes of depression may in fact be distinct clinical syndromes.
BACKGROUND:Psychotic depression (PD) is classified as a subtype of severe depression in the current diagnostic manuals. Accordingly, it is a common conception among psychiatrists that psychotic features in depression arise as a consequence of depressive severity. The aim of this study was to determine whether the severity of depressive and psychotic symptoms correlate in accordance with this "severity-psychosis" hypothesis and to detect potential differences in the clinical features of PD and non-psychotic depression (non-PD). METHODS: Quantitative analysis of Health of the Nation Outcome Scales (HoNOS) scores from all patients admitted to a Danish general psychiatric hospital due to a severe depressive episode in the period between 2000 and 2010 was performed. RESULTS: A total of 357 patients with severe depression, of which 125 (35%) were of the psychotic subtype, formed the study sample. Mean HoNOS scores at admission differed significantly between patients with non-PD and PD on the items hallucinations and delusions (non-PD=0.33 vs. PD=1.37, p<0.001), aggression (non-PD=0.20 vs. PD=0.36, p=0.044) and on the total score (non-PD=10.55 vs. PD=11.87, p=0.024). The HoNOS scores on the two items "depression" and "hallucinations and delusions" were very weakly correlated. LIMITATIONS: Diagnoses were based on normal clinical practice and not formalized research criteria. CONCLUSIONS: The symptomatology of PD and non-PD differs beyond the mere psychosis. Furthermore, severity ratings of depressive and psychotic symptoms are very weakly correlated. These findings offer further support to the hypothesis stating that the psychotic- and non-psychotic subtypes of depression may in fact be distinct clinical syndromes.
Authors: Tara Kingston; Paul J Scully; David J Browne; Patrizia A Baldwin; Anthony Kinsella; Eadbhard O'Callaghan; Vincent Russell; John L Waddington Journal: CNS Neurosci Ther Date: 2018-03-25 Impact factor: 5.243
Authors: S D Østergaard; B S Meyers; A J Flint; B H Mulsant; E M Whyte; C M Ulbricht; P Bech; A J Rothschild Journal: Acta Psychiatr Scand Date: 2013-06-25 Impact factor: 6.392
Authors: S D Østergaard; A J Rothschild; A J Flint; B H Mulsant; E M Whyte; A K Leadholm; P Bech; B S Meyers Journal: Acta Psychiatr Scand Date: 2015-05-27 Impact factor: 6.392
Authors: Søren D Østergaard; Barnett S Meyers; Alastair J Flint; Benoit H Mulsant; Ellen M Whyte; Christine M Ulbricht; Per Bech; Anthony J Rothschild Journal: J Affect Disord Date: 2014-01-02 Impact factor: 4.839
Authors: Olabisi Owoeye; Tara Kingston; Paul J Scully; Patrizia Baldwin; David Browne; Anthony Kinsella; Vincent Russell; Eadbhard O'Callaghan; John L Waddington Journal: Schizophr Bull Date: 2013-05-28 Impact factor: 9.306