Psychotic depression
Psychotic depression, also known as depressive psychosis, is a major depressive episode that is accompanied by psychotic symptoms. It can occur in the context of bipolar disorder or major depressive disorder. It can be difficult to distinguish from schizoaffective disorder, a diagnosis that requires the presence of psychotic symptoms for at least two weeks without any mood symptoms present. Unipolar psychotic depression requires that psychotic symptoms occur during severe depressive episodes, although residual psychotic symptoms may also be present in between episodes (e.g., during remission, mild depression, etc.). Diagnosis using the DSM-5 involves meeting the criteria for a major depressive episode, along with the criteria for "mood-congruent or mood-incongruent psychotic features" specifier.
| Psychotic depression | |
|---|---|
| Other names | Depressive psychosis |
| A drawing that attempts to capture the sadness, loneliness, and detachment from reality, as described by patients with psychotic depression | |
| Specialty | Psychiatry |
| Symptoms | Hallucinations, delusions, anhedonia |
| Complications | risk of harm to self or other, risk of relapse of psychotic depression |
| Usual onset | 20-40 years old |
| Duration | Days to weeks, sometimes longer |
| Diagnostic method | Clinical interview |
| Differential diagnosis | Schizoaffective disorder, schizophrenia, personality disorders, dissociative disorders |
| Treatment | Medication, cognitive behavioral therapy |
| Medication | Anti-depressants, anti-psychotics |