The clinical and neuroendocrine features of psychotic depression.

The authors compared 65 patients with major depression and psychotic features to 192 patients with major depression and no psychotic features in terms of clinical features, family history, and hypothalamic-pituitary-adrenocortical axis function. In accord with other studies, patients with psychotic depression were more likely to have bipolar depression, psychomotor disturbance, a family history of schizophrenia, and a more severely disordered hypothalamic-pituitary-adrenocortical axis. Whether psychotic depression is best considered apart from nonpsychotic depression or as simply a more severe form of depression remains unsettled. Nevertheless, research to date does give the diagnosis of psychotic depression a practical significance which is enhanced by its simplicity.