Psychotic versus non-psychotic major depressive disorder: A comparative naturalistic study

Massimiliano Buoli, Alice Caldiroli, Alfredo Carlo Altamura

Research output: Contribution to journalArticlepeer-review


Objective: Psychotic depressed patients were found to have more severe cognitive deficits, poorer treatment response and higher suicidal risk respect to non-psychotic depressives. Aim of the present research was to compare clinical variables and outcome between psychotic and non-psychotic major depressive patients. Method: A sample of 36 major depressed patients was divided into two groups according to the presence of psychotic symptoms. Structured Clinical Interview for DSM (SCID-I) and Hamilton Depression Rating Scale (HAM-D) were administered to the patients at baseline by trained raters. One-way analysis of variance (ANOVAs) and chi-square tests were performed to compare the two groups. Binary logistic regression was performed to assess the risk of lack of response/remission in patients with psychotic symptoms and the risk of developing psychotic symptoms in major depressives with a family history of schizophrenia or bipolar disorder. Results: Psychotic major depressives presented more severe illness as showed by HAM-D baseline scores (F=17.20, p2=16.22, p=0.027). Psychotic symptoms were predictive of lack of remission (OR=4.09, p=0.05) and family history of schizophrenia/psychotic bipolar disorder was associated with psychotic major depression (OR=10.81, p=0.04). Conclusions: Patients with psychotic symptoms present a more severe course of illness as showed by long hospitalizations and lower rates of remission. Psychotic depressives show more frequently a family history of "major psychoses" suggesting a continuum in psychotic disorders and a genetic association of major psychotic depression with bipolar disorder and schizophrenia.

Original languageEnglish
Pages (from-to)333-337
Number of pages5
JournalAsian Journal of Psychiatry
Issue number4
Publication statusPublished - Aug 2013


  • Family history
  • Major psychotic depression
  • Remission

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Psychology(all)


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