Psychiatry Investig.
2014 Jul;11(3):281-289.
Distinctive Clinical Correlates of Psychotic Major Depression: The CRESCEND Study
- Affiliations
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- 1Department of Psychiatry, Yong-In Mental Hospital, Yongin, Republic of Korea.
- 2Institute of Mental Health, Hanyang University, Seoul, Republic of Korea. hypyc@hanyang.ac.kr
- 3Department of Psychiatry, College of Medicine, Soonchunhyang University, Asan, Republic of Korea.
- 4Department of Psychiatry, College of Medicine, Dongguk University, Gyeongju, Republic of Korea.
- 5Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
- 6Department of Psychiatry, College of Medicine, Korea University, Seoul, Republic of Korea.
- 7Department of Psychiatry, School of Medicine, Chonnam National University, Gwangju, Republic of Korea.
- 8Department of Psychiatry, Keimyung University School of Medicine, Daegu, Republic of Korea.
- 9Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
- 10Department of Psychiatry, College of Medicine, Hanyang University, Seoul, Republic of Korea.
Abstract
OBJECTIVE
The purpose of this investigation was to identify distinctive clinical correlates of psychotic major depression (PMD) as compared with non-psychotic major depression (NPMD) in a large cohort of Korean patients with major depressive disorder (MDD).
METHODS
We recruited 966 MDD patients of age over 18 years from the Clinical Research Center for Depression of South Korea (CRESCEND) study. Diagnoses of PMD (n=24) and NPMD (n=942) were made with the DSM-IV definitions and confirmed with SCID. Psychometric scales were used to assess overall psychiatric symptoms (BPRS), depression (HAMD), anxiety (HAMA), global severity (CGI-S), suicidal ideation (SSI-Beck), functioning (SOFAS), and quality of life (WHOQOL-BREF). Using independent t-tests and chi2 tests, we compared clinical characteristics of patients with PMD and NPMD. A binary logistic regression model was constructed to identify factors independently associated with increased likelihood of PMD.
RESULTS
PMD subjects were characterized by a higher rate of inpatient enrollment, and higher scores on many items on BPRS (somatic concern, anxiety, emotional withdrawal, guilt feelings, tension, depression, suspiciousness, hallucination, motor retardation, blunted affect and excitement) global severity (CGI-s), and suicidal ideation (SSI-Beck). The explanatory factor model revealed that high levels of tension, excitement, and suicidal ideation were associated with increased likelihood of PMD.
CONCLUSION
Our findings partly support the view that PMD has its own distinctive clinical manifestation and course, and may be considered a diagnostic entity separate from NPMD.
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