An Update on Psychotic Depression

There has been a debate since the 1980’s whether delusional depression or psychotic depression is a distinct psychiatric disorder. (Glassman & Roose, 1981) Currently, DSM-IVTR classifies psychotic symptoms in patients with major depressive disorder as a severity specifier. However, researchers in the area of major depressive disorder, with psychotic features (PMD) believe that PMD is a distinct disorder based on not only the phenomenological presentation, but family studies, course of illness, biological findings, and treatment as well. This lack of recognition of PMD as being a distinct disorder has contributed to the limited amount of research funding for this disorder in spite of a prevalence in the general population of 0.4-0.6%. (Johnson et al., 1991; Ohayon and Schatzberg, 2002) This chapter will provide an update on studies that support PMD as being a distinct psychiatric disorder.