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Cited by 109Treatment of Major DepressionMental Health Treatment and AccessSchizophrenia research and treatment

Prevalence and clinical characteristics of psychotic versus nonpsychotic major depression in a general psychiatric outpatient clinic.

Open access
Gaudiano, Brandon A., Dalrymple, Kristy L., Zimmerman, Mark·2009·Depression and Anxiety
DOI 10.1002/da.20470PMC PMC3111977
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Abstract

BACKGROUND: Psychotic major depression (PMD) is a severe mental disorder characterized by high levels of illness severity, chronicity, impairment, and treatment resistance. However, most past research on PMD has been conducted in inpatient hospital samples, and relatively little is known about PMD patients presenting for treatment in the community specifically. METHODS: In this study, we examined the prevalence and clinical characteristics of PMD in a large sample (n=2,500) of treatment-seeking outpatients who were administered structured clinical interviews by trained diagnosticians. RESULTS: Of the patients diagnosed with major depression, 5.3% had psychotic features. PMD patients were more likely to be members of a racial/ethnic minority and to have lower educational attainment compared to those with nonpsychotic major depression. In addition, PMD patients were found to have greater current depression severity, suicidal ideation, and social and work impairment. These patients also were more likely to have histories of suicide attempts and psychiatric hospitalizations, to report an earlier age of illness onset, and to meet criteria for chronic depression. In terms of psychiatric comorbidity, PMD patients had higher rates of certain anxiety disorders as well as more somatoform and cluster A personality disorders. CONCLUSIONS: Results indicated that PMD was present in a relatively small percentage of treatment-seeking outpatients but was associated with disproportionately high levels of severity and impairment. Similarities and differences between the current findings and those from past research are discussed, including clinical implications for the identification and treatment of PMD in routine practice settings.

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  • Comorbid depression and psychosis is linked to greater illness severity, functional impairment, and treatment resistance than either condition alone.

    “Depression and psychosis frequently co-occur,1–3, and this pattern of comorbidity is associated with increased illness severity, functional impairment, and treatment resistance compared with either disorder alone.2,4,5”

    From Acceptance-based Behavior Therapy for Depression With Psychosis (2015) · cites this paper as [2]

    The Results section reports greater depression severity and social and work impairment in patients with psychotic major depression than in those with nonpsychotic major depression. The Introduction reports higher treatment resistance in the same comparison. The paper does not compare this group with patients who have psychosis alone, so it does not support the claim’s full ‘either disorder alone’ comparison. (LLM, conf=0.88)

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  • Between 33 and 66% of patients suffering from MDD have a psychiatric comorbidity that could potentially exclude them from psychedelic-assisted therapy.

    “Between 33 and 66% of patients suffering from MDD have a psychiatric comorbidity that could potentially exclude them from psychedelic-assisted therapy”

    From Psychedelics and Other Psychoplastogens for Treating Mental Illness. (2021) · cites this paper as [268]

    The Results section (Psychiatric Comorbidity; page unavailable) reports psychiatric comorbidities among outpatients with major depression, including higher rates of PTSD and OCD in those with psychotic features. It does not establish that 33–66% of patients with MDD have a potentially exclusionary comorbidity, or assess eligibility for psychedelic-assisted therapy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Depression and psychosis often occur together.

    “Depression and psychosis frequently co-occur,1–3, and this pattern of comorbidity is associated with increased illness severity, functional impairment, and treatment resistance compared with either disorder alone.2,4,5”

    From Acceptance-based Behavior Therapy for Depression With Psychosis (2015) · cites this paper as [2]

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Authors
Gaudiano, B. A., Dalrymple, K. L., & Zimmerman, M.
Affiliations
Brown University (US)
Corresponding author
Gaudiano, Brandon A.
ORCID
Venue
Depression and Anxiety
Publisher
Hindawi Limited
Published
2009-01
Volume
26
Issue
1
Pages
54-64
ISSN
  • 1091-4269 (ISSN-L)
  • 1520-6394
DOI
10.1002/da.20470
PMC
PMC3111977
OpenAlex
W2155186557
Cited by
108
References
57
Citations by year
2026: 12 · 2025: 4 · 2024: 12 · 2023: 23 · 2022: 5 · 2021: 10 · 2020: 5 · 2019: 4 · 2018: 2 · 2017: 4 · 2016: 4 · 2015: 2 · 2014: 3 · 2013: 6 · 2012: 4
FWCI
1.87
Type
journal article
Language
en
Open access
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 2434 d)
Locations
  • Depression and Anxiety (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (K23MH076937)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
psychotic depression, prevalence, clinical features, educational attainment, depression severity, suicidal ideation, suicide attempts, psychiatric hospitalization, chronic depression, psychiatric comorbidity, anxiety disorders, somatoform disorders, Cluster A personality disorders
MeSH terms
Adult, Affective Disorders, Psychotic, Anxiety Disorders, Cross-Sectional Studies, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Outpatient Clinics, Hospital, Patient Acceptance of Health Care, Personality Assessment, Rhode Island, Risk Factors, Socioeconomic Factors, Somatoform Disorders, Reproducibility of Results, Comorbidity

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