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dc.contributor.authorSchatzberg, Alan F.
dc.contributor.authorRothschild, Anthony J.
dc.date2022-08-11T08:10:27.000
dc.date.accessioned2022-08-23T17:09:23Z
dc.date.available2022-08-23T17:09:23Z
dc.date.issued1992-06-01
dc.date.submitted2010-05-05
dc.identifier.citationAm J Psychiatry. 1992 Jun;149(6):733-45.
dc.identifier.issn0002-953X (Linking)
dc.identifier.pmid1590491
dc.identifier.urihttp://hdl.handle.net/20.500.14038/45810
dc.description.abstractTo review data supporting or not supporting the designation of unipolar psychotic major depression as a distinct syndrome in DSM-IV, the authors used computerized literature searches to identify reports of studies that have directly compared the characteristics, biology, familial transmission, course/outcome, and response to treatment of psychotic and nonpsychotic major depression. The review showed that statistically significant differences between the two types of depression have been found on each of these dimensions. There are greater guilt feelings and psychomotor disturbance, among other features, in psychotic depression. Studies have found significant differences between patients with psychotic and nonpsychotic depression in glucocorticoid activity, dopamine beta-hydroxylase activity, levels of dopamine and serotonin metabolites, sleep measures, and ventricle-to-brain ratios. Family studies show higher rates of bipolar disorder in first-degree relatives of probands with psychotic major depression than of probands with nonpsychotic major depression. Greater morbidity and residual impairment have also been reported in patients with psychotic major depression, and they respond more poorly to placebo and to tricyclic antidepressants. Differences between patients with psychotic and nonpsychotic major depression on many of these measures were not due to differences in severity or endogenicity. Since the data indicate that psychotic and nonpsychotic major depression can be separated, the frequency with which the diagnosis of psychotic major depression is missed and its unique course and response to treatment point to the practical importance of a separate diagnosis for this disorder. However, further studies are needed to resolve important methodological issues and to develop an optimal set of operational criteria.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=1590491&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://ajp.psychiatryonline.org/cgi/content/abstract/149/6/733
dc.subjectAntidepressive Agents, Tricyclic
dc.subjectDelusions
dc.subjectDepressive Disorder
dc.subjectDiagnosis, Differential
dc.subjectGuilt
dc.subjectHumans
dc.subjectPlacebos
dc.subjectPsychiatric Status Rating Scales
dc.subjectPsychomotor Disorders
dc.subjectSleep
dc.subjectTerminology as Topic
dc.subjectPsychiatry
dc.titlePsychotic (delusional) major depression: should it be included as a distinct syndrome in DSM-IV
dc.typeJournal Article
dc.source.journaltitleThe American journal of psychiatry
dc.source.volume149
dc.source.issue6
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/psych_pp/34
dc.identifier.contextkey1299381
html.description.abstract<p>To review data supporting or not supporting the designation of unipolar psychotic major depression as a distinct syndrome in DSM-IV, the authors used computerized literature searches to identify reports of studies that have directly compared the characteristics, biology, familial transmission, course/outcome, and response to treatment of psychotic and nonpsychotic major depression. The review showed that statistically significant differences between the two types of depression have been found on each of these dimensions. There are greater guilt feelings and psychomotor disturbance, among other features, in psychotic depression. Studies have found significant differences between patients with psychotic and nonpsychotic depression in glucocorticoid activity, dopamine beta-hydroxylase activity, levels of dopamine and serotonin metabolites, sleep measures, and ventricle-to-brain ratios. Family studies show higher rates of bipolar disorder in first-degree relatives of probands with psychotic major depression than of probands with nonpsychotic major depression. Greater morbidity and residual impairment have also been reported in patients with psychotic major depression, and they respond more poorly to placebo and to tricyclic antidepressants. Differences between patients with psychotic and nonpsychotic major depression on many of these measures were not due to differences in severity or endogenicity. Since the data indicate that psychotic and nonpsychotic major depression can be separated, the frequency with which the diagnosis of psychotic major depression is missed and its unique course and response to treatment point to the practical importance of a separate diagnosis for this disorder. However, further studies are needed to resolve important methodological issues and to develop an optimal set of operational criteria.</p>
dc.identifier.submissionpathpsych_pp/34
dc.contributor.departmentDepartment of Psychiatry
dc.source.pages733-45


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