Challenges in the Treatment of Major Depressive Disorder With Psychotic Features

Anthony J. Rothschild


Schizophr Bull. 2013;39(4):787-796. 

In This Article

Relationship of Psychotic Depression to Bipolar Disorder

Whether there is a relationship between psychotic depression and bipolar disorder has intrigued investigators for many years. Several studies have demonstrated that patients with psychotic depression, particularly those with an early age of onset, may have a higher risk than nonpsychotic depressed patients of subsequently developing bipolar disorder.[18–21] In addition, relatives of patients with psychotic depression have a higher prevalence of bipolar disorder compared with the relatives of patients with nonpsychotic depression,[22–24] and depressed relatives of patients with bipolar disorder are more likely to suffer from the psychotic subtype compared with depressed relatives of healthy controls.[25] A parental history of bipolar disorder has been shown to be a risk factor for psychotic depression but not for nonpsychotic depression.[26]