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Heterogeneity in psychotic depression
Journal article   Peer reviewed

Heterogeneity in psychotic depression

William Coryell, Bruce Pfohl and Mark Zimmerman
Comprehensive psychiatry, Vol.27(5), pp.430-438
1986
DOI: 10.1016/0010-440X(86)90030-1
PMID: 3757491

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Abstract

Earlier data suggests that some patients with major depression and psychotic features are misdiagnosed and have, instead, schizophrenia. To explore methods for clinically isolating such patients, the authors evaluated three alternative ways of subdividing 65 inpatients with psychotic major depression using historical, diagnostic, phenomenological, neuroendocrine, family history, and follow-up measures. Older patients, those with mood-congruent psychotic features only and those with abnormal dexamethasone suppression test (DST) results, were distinguished by a limited number of features more typical of manic depressive disease as traditionally described. While none of these three subdivisions had clear prognostic value by itself, the combination of youth, mood-incongruent psychotic features, and normal DST results predicted a recovery rate during a 6-month follow-up one third that for the remaining patients.

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