Site Map

Major depression with psychotic features

Psychotic depression; Delusional depression

Major depression with psychotic features is a mental disorder in which a person has depression along with loss of touch with reality (psychosis).

Images

Forms of depression

I Would Like to Learn About:

Causes

The cause is unknown. A family or personal history of depression or psychotic illness makes you more likely to develop this condition.

Symptoms

People with psychotic depression have symptoms of depression and psychosis.

Psychosis is a loss of contact with reality. It usually includes:

The types of delusions and hallucinations are often related to your depressed feelings. For example, some people may hear voices criticizing them, or telling them that they don't deserve to live. The person may develop false beliefs about their body, such as believing that they have cancer.

Exams and Tests

Your health care provider will perform a physical exam and ask questions about your medical history and symptoms. Your answers and certain questionnaires can help your provider diagnose this condition and determine how severe it may be.

Blood and urine tests, and possibly a brain scan may be done to rule out other medical conditions with similar symptoms.

Treatment

Psychotic depression requires immediate medical care and treatment.

Treatment usually involves antidepressant and antipsychotic medicine. You may only need antipsychotic medicine for a short period of time.

Electroconvulsive therapy can help treat depression with psychotic symptoms. However, medicine is usually tried first.

Outlook (Prognosis)

This is a serious condition. You will need immediate treatment and close monitoring by a provider.

You may need to take medicine for a long time to prevent the depression from coming back. Depression symptoms are more likely to return than psychotic symptoms.

Possible Complications

The risk for suicide is much higher in people with depression with psychotic symptoms than in those without psychosis. You may need to stay in the hospital if you have thoughts of suicide. The safety of other people must also be considered.

When to Contact a Medical Professional

If you are thinking about hurting yourself or others, call 911 or the local emergency number right away. Or, go to the hospital emergency room. DO NOT delay.

You can also call the National Suicide Prevention Lifeline at 1-800-273-8255 (1-800-273-TALK), where you can receive free and confidential support anytime day or night.

Contact your provider right away if:

Related Information

Major depression
Psychosis

References

American Psychiatric Association. Major depressive disorder. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013:160-168.

Fava M, Østergaard SD, Cassano P. Mood disorders: depressive disorders (major depressive disorder). In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 29.

BACK TO TOP

Review Date: 11/7/2020  

Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

ADAM Quality Logo

A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics. This site complies with the HONcode standard for trustworthy health information: verify here.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2022 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.