Sub-typing depression, II. Clinical distinction of psychotic depression and non-psychotic melancholia.

Abstract:

:We 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.

journal_name

Psychol Med

journal_title

Psychological medicine

authors

Parker G,Hadzi-Pavlovic D,Brodaty H,Austin MP,Mitchell P,Wilhelm K,Hickie I

doi

10.1017/s0033291700035078

subject

Has Abstract

pub_date

1995-07-01 00:00:00

pages

825-32

issue

4

eissn

0033-2917

issn

1469-8978

journal_volume

25

pub_type

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