Psychotic major depression in older people: a systematic review

Gournellis, Rossetos; Oulis, Panagiotis; Howard, Robert

doi:10.1002/gps.4065

Cited by 32 publications

(23 citation statements)

References 66 publications

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“…We investigated the contribution of age as a potential effect modifier due to the fact that PMD in old‐age might manifest considerable differentiations in comparison with PMD of younger adults, differentiations that might exert their influence in suicidal behavior. PMD in older people might become more prevalent in the community, and it presents greater burden of brain abnormalities such as more atrophy and vascular disease (see for review). Lastly, late‐onset PMD compared to early‐onset PMD presents more prevalent delusional beliefs of somatic and impending disaster type .…”

Section: Discussionmentioning

confidence: 99%

“…Psychotic major depression (PMD) is characterized by the presence of psychotic features—delusions and/or hallucinations—during a major depressive episode. Unipolar PMD has been shown to present different clinical characteristics, neurobiological correlates, family history, prognosis, and treatment response compared to non‐PMD raising questions as to whether PMD in the context of unipolar depression might even constitute a distinct clinical entity, different from non‐PMD (see for reviews).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Psychotic (delusional) depression and suicidal attempts: a systematic review and meta‐analysis

Gournellis

Tournikioti

Touloumi

et al. 2017

Acta Psychiatr Scand

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Psychotic (delusional) depression and suicidal attempts: a systematic review and meta‐analysis

Gournellis

Tournikioti

Touloumi

et al. 2017

Acta Psychiatr Scand

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“…In general, major depression is a highly heterogeneous disorder [34]. It is known that there are clinical differences between PMD that has its onset in early adulthood and PMD in old age [19,35]. Therefore, further re nements in screening and treatment are needed for this clinical population.…”

Section: Resultsmentioning

confidence: 99%

Clinical characteristics and socio-demographic features of psychotic major depression

Wang

Hao

et al. 2020

Preprint

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Background Psychotic major depression (PMD) is a special subtype of depression with a worse prognosis. Previous studies failed to find many differences among patients with PMD versus those with non-psychotic major depression (NMD) or schizophrenia(SZ). This study compared psychotic major depression with non-psychotic major depression and schizophrenia based on sociodemographic factors (including season of conception) and clinical characteristics. We aimed to provide data to inform clinical diagnoses and etiology research. Methods This case–control study used data for patients admitted to Shandong Mental Health Center from June 1, 2016 to December 31, 2017. We analyzed cases that had experienced a PMD episode (International Classification of Diseases, Tenth Revision codes F32.3, F33.3), NMD (F32.0–2/9, F33.0–2/9), and SZ (F20–20.9). Data were collected on sex, main discharge diagnosis, birth date, ethnicity, family history of psychiatric diagnoses, marital status, age at first onset, educational attainment, allergy history, and existence of trigger events. Results Patients with depression with a primary school/below education (odds ratio [OR] 0.397, CI: 0.18–0.874) and without a family history (OR 0.557, CI: 0.332–0.937) were less likely to have psychotic symptoms than other patients. Compared with patients with PMD, a primary school/below education (OR 3.646, CI: 1.65–8.053), no allergy history (OR 2.2, CI: 1.152–4.2), trigger events experienced before first onset (OR 2.428, CI: 1.528–3.859), being unmarried (OR 0.3, CI: 0.104–0.871), and an earlier age at first onset (OR 0.931, CI: 0.911–0.952) were features of SZ. Conclusion PMD and NMD are similar in terms of patients’ demographic variables and clinical characteristics, whereas there are differences between PMD and SZ. The significant factors we identified may point to underlying heterogeneity of these diseases.

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“…It is possible that internal heterogeneity of the diagnostic category of PD partly causes the lack of findings. It is already known that there are significant clinical differences between psychotic depression that has its onset in early adulthood versus psychotic depression in old age [2,37]. In addition, major depression in general is a highly heterogeneous entity [38].…”

Section: Discussionmentioning

confidence: 99%

Early childhood and adolescent risk factors for psychotic depression in a general population birth cohort sample

Nietola

Huovinen

Heiskala

et al. 2020

Soc Psychiatry Psychiatr Epidemiol

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Background and purpose In the group of severe mental disorders, psychotic depression (PD) is essentially under-researched. Knowledge about the risk factors is scarce and this applies especially to early risk factors. Our aim was to study early childhood and adolescent risk factors of PD in a representative birth cohort sample with a follow-up of up to 50 years. Methods The study was carried out using the Northern Finland Birth Cohort 1966 (NFBC 1966). We used non-psychotic depression (NPD) (n = 746), schizophrenia (SZ) (n = 195), psychotic bipolar disorder (PBD) (n = 27), other psychoses (PNOS) (n = 136) and healthy controls (HC) (n = 8200) as comparison groups for PD (n = 58). We analysed several potential early risk factors from time of birth until the age of 16 years. Results The main finding was that parents' psychiatric illness [HR 3.59 (1.84-7.04)] was a risk factor and a high sports grade in school was a protective factor [HR 0.29 (0.11-0.73)] for PD also after adjusting for covariates in the multivariate Cox regression model. Parental psychotic illness was an especially strong risk factor for PD. The PD subjects had a parent with psychiatric illness significantly more often (p < 0.05) than NPD subjects. Differences between PD and other disorder groups were otherwise small. Conclusions A low sports grade in school may be a risk factor for PD. Psychiatric illnesses, especially psychoses, are common in the parents of PD subjects. A surprisingly low number of statistically significant risk factors may have resulted from the size of the PD sample and the underlying heterogeneity of the etiology of PD.

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Psychotic major depression in older people: a systematic review

Cited by 32 publications

References 66 publications

Psychotic (delusional) depression and suicidal attempts: a systematic review and meta‐analysis

Psychotic (delusional) depression and suicidal attempts: a systematic review and meta‐analysis

Clinical characteristics and socio-demographic features of psychotic major depression

Early childhood and adolescent risk factors for psychotic depression in a general population birth cohort sample

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