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Forms of depression
Forms of depression


Definition:

Major depression with psychotic features is a condition in which a person experiences depression along with reduced contact with reality (psychosis). This can take the form of false beliefs (delusions) or seeing or hearing something that isn't really there (hallucinations).

See also:



Alternative Names:

Psychotic depression; Delusional depression



Causes, incidence, and risk factors:

Although there are no obvious risk factors, a family history of depression or psychotic illness increases the chances of developing this condition.



Symptoms:

This condition occurs when a depressed person loses touch with reality and hallucinates or has delusions. People with psychotic depression have the combined symptoms of depression and psychosis.

The content of the delusions and hallucinations can be consistent with depression. For example, some people hear voices criticizing them, telling them that they are not good enough or evil, or telling them that they don't deserve to live and should kill themselves. Psychotic depression requires immediate medical attention to prevent self-harm or harm to others.



Signs and tests:

Diagnosis involves:

  • Psychiatric evaluation
  • Physical examination
  • Laboratory tests

The health care provider should rule out other medical conditions that can cause the same symptoms (such as reactions to certain drugs).



Treatment:

Treatment usually involves antidepressant and antipsychotic medication. Patients sometimes take antipsychotics briefly. Electroconvulsive therapy is very effective for this condition, but it is generally used after medication.



Support Groups:



Expectations (prognosis):

Having psychotic symptoms with depression is a serious condition. The depressive symptoms have a higher chance of returning than the psychotic symptoms. You may need to take medication for a long time to prevent depression from returning.

Ongoing treatment and monitoring offer the best chance of recovery.



Complications:

Suicide or other self-harm is the most serious complication. You may need to stay in the hospital if you have thoughts of suicide. The safety of others must also be considered.



Calling your health care provider:

Call your health care provider if you or someone you know experiences depression or psychosis.



Prevention:



References:

Jarema M. Atypical antipsychotics in the treatment of mood disorders. Curr Opin Psychiatry. 2007;20:23-29.




Review Date: 1/15/2009
Reviewed By: Christos Ballas, MD, Attending Psychiatrist, Hospital of the University of Pennsylvania, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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