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New Approaches to Managing Psychotic Depression

Alan F. Schatzberg, MD

Published: January 1, 2003

Article Abstract

Major depression with psychotic features, while fairly common, is frequently misdiagnosed.Symptoms seen in these patients are those of an overall severe depressive disorder with psychomotorimpairment (retardation or agitation), guilt, suicidal preoccupation, and neuropsychological impairment.A number of biological characteristics and behavioral symptoms are specific to patients sufferingfrom psychotic depression and differ significantly from those of nonpsychotic depression. Psychoticdepression is seen in patients of all ages, and it has a high short-term morbidity and risk ofsuicide. Data support the use of antipsychotics in combination with antidepressants for major depressionwith psychotic features, but other treatments may have as great or greater efficacy for the disorder.This article focuses on recognizing the features of psychotic depression, the success of currenttreatment options, and new treatments under investigation.

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