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Case 20 - “I Am Staying Here Illegally”

Major Depressive Disorder with Psychosis

Published online by Cambridge University Press:  aN Invalid Date NaN

Matthew Gibfried
Affiliation:
Saint Louis University School of Medicine, Missouri
George T. Grossberg
Affiliation:
Saint Louis University School of Medicine, Missouri
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Summary

Those with depression with psychosis meet the criteria for diagnosis of depression but also experience psychotic symptoms. When individuals with major depressive disorder (MDD) experience delusions, hallucinations, or catatonic symptoms, it is referred to as MDD with psychotic psychosis, also known as psychotic depression. The nature of the psychosis in those with depression is usually mood-congruent somatic, pessimistic, or guilt-related delusions. It is crucial for healthcare providers to diagnose psychotic depression early due to its high risk of suicide and poor response to antidepressant treatment alone. Additional antipsychotic medication is typically necessary, in addition to the antidepressant, for an effective response. Electroconvulsive therapy is more commonly used in those with severe depression with suicidality, catatonia, and those with psychotic depression. Studies have shown a response rate of 70-90% with electroconvulsive therapy in those with severe depression.

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Chapter
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Clinical Case Studies in Long-Term Care Psychiatry
Navigating Common Mental Health Challenges in Geriatric Care
, pp. 98 - 102
Publisher: Cambridge University Press
Print publication year: 2024

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References

References

Jääskeläinen, E., Juola, T., Korpela, H., Lehtiniemi, H., Nietola, M., Korkeila, J., & Miettunen, J. (2018). Epidemiology of psychotic depression: Systematic review and meta-analysis. Psychological Medicine, 48 (6), 905918.CrossRefGoogle ScholarPubMed
Zalpuri, I., & Rothschild, A. J. (2016). Does psychosis increase the risk of suicide in patients with major depression? A systematic review. Journal of Affective Disorders, 198, 2331.CrossRefGoogle ScholarPubMed

Further Reading

Desai, A., & Grossberg, G. (2017). Psychiatric Consultation in Long-Term Care (A Guide for Healthcare Professionals) (Cambridge University Press.) p. 125.Google Scholar
Goegan, S. A., Hasey, G. M., King, J. P., Losier, B. J., Bieling, P. J., McKinnon, M. C., & McNeely, H. E. (2022). Naturalistic study on the effects of electroconvulsive therapy (ECT) on depressive symptoms. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 67 (5), 351360. https://doi.org/10.1177/07067437211064020CrossRefGoogle Scholar
Lloyd, J. R., Silverman, E. R., Kugler, J. L., & Cooper, J. J. (2019). Electroconvulsive therapy for patients with catatonia: Current perspectives. Neuropsychiatric Disease and Treatment, 16, 21912208. https://doi.org/10.2147/NDT.S231573CrossRefGoogle Scholar
Neufeld, N. H., Kaczkurkin, A. N., Sotiras, A., Mulsant, B. H., Dickie, E. W., Flint, A. J., Meyers, B. S., Alexopoulos, G. S., Rothschild, A. J., Whyte, E. M., Mah, L., Nierenberg, J., Hoptman, M. J., Davatzikos, C., Satterthwaite, T. D., & Voineskos, A. N. (2020). Structural brain networks in remitted psychotic depression. Neuropsychopharmacology, 45 (7), 12231231. https://pubmed.ncbi.nlm.nih.gov/32109935/CrossRefGoogle ScholarPubMed
Wu, Z., Su, G., Lu, W., Liu, L., Zhou, Z., & Xie, B. (2021). Clinical symptoms and their relationship with cognitive impairment in elderly patients with depressive disorder. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.1009653Google Scholar

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