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Is depression severity the sole cause of psychotic symptoms during an episode of unipolar major depression? A study both between and within subjects

Forty, Elizabeth, Jones, Lisa, Jones, Ian Richard, Cooper, Carly, Russell, Elen, Farmer, Anne, McGuffin, Peter and Craddock, Nicholas John 2009. Is depression severity the sole cause of psychotic symptoms during an episode of unipolar major depression? A study both between and within subjects. Journal of Affective Disorders 114 (1-3) , pp. 103-109. 10.1016/j.jad.2008.06.012

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Abstract

Background Despite the common clinical assumption that psychosis is an indicator of severity in depression, it is not known what determines the presence of psychotic features in major depression. Our aim was to answer the question: Is depression severity the sole cause of psychotic symptoms during an episode of unipolar major depression? Methods In a sample of 585 patients from the UK, meeting criteria for both DSM-IV and ICD-10 major recurrent depression, we assessed measures of severity of depression and the presence of psychotic features, both within and between subjects. Results Within patients, psychotic episodes tended to be more severe than non-psychotic episodes. However, between patients there was wide variation in severity in both those that did, and did not, experience psychotic episodes. Limitations We used retrospective interview information together with case note data. Our cases may not be typical of usual case loads because they were selected to avoid family history of bipolar illness or schizophrenia. Conclusions Individuals with a predisposition to psychotic features tend to display such features during more severe episodes of depression. However, patients with no history of psychosis may experience non-psychotic depressive episodes of equal or greater severity, in terms of depressive symptomatology, compared to patients with psychotic depression. Thus, there is individual variation in susceptibility to psychosis during mood episodes and severity is not the sole determinant.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Uncontrolled Keywords: major recurrent depression, psychosis, unipolar, severity
Publisher: Elsevier
ISSN: 0165-0327
Last Modified: 04 Jun 2017 03:44
URI: http://orca.cf.ac.uk/id/eprint/25725

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