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psychotic depression
Psychotic depression, also known as depressive psychosis, is a major depressive episode that is accompanied by psychotic symptoms.〔Hales E and Yudofsky JA, eds, The American Psychiatric Press Textbook of Psychiatry, Washington, DC: American Psychiatric Publishing, Inc., 2003〕 It can occur in the context of bipolar disorder or major depressive disorder.〔 It can be difficult to distinguish from schizoaffective disorder; that disorder requires the presence of psychotic symptoms for at least two weeks without any mood symptoms present.〔 Diagnosis using the DSM-IV involves meeting the criteria for a major depressive episode, along with the criteria for the "psychotic features" specifier.
== Symptoms ==
Individuals with psychotic depression experience the symptoms of a major depressive episode, along with one or more psychotic symptoms, including delusions and/or hallucinations.〔 Delusions can be classified as mood congruent or incongruent, depending on whether or not the nature of the delusions is in keeping with the individual's mood state.〔 Common themes of mood congruent delusions include guilt, punishment, personal inadequacy, or disease. Half of patients experience more than one kind of delusion.〔 Delusions occur without hallucinations in about one-half to two-thirds of patients with psychotic depression.〔 Hallucinations can be auditory, visual, olfactory (smell), or haptic (touch).〔
Severe anhedonia, loss of interest, and psychomotor retardation are typically present.〔Rothschild, A.J., 2009. Clinical Manual for Diagnosis and Treatment of Psychotic Depression. American Psychiatric Publishing, Inc. Washington DC, USA ISBN 978-1-58562-292-4〕
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