Challenges in the Treatment of Major Depressive Disorder With Psychotic Features

Anthony J. Rothschild


Schizophr Bull. 2013;39(4):787-796. 

In This Article

Distinction Between Psychotic Depression and Schizophrenia

By definition, in both DSM-IV and DSM-V, the psychotic symptoms in major Depressive disorder with psychotic features are episodic and occur only during an episode of major depression. In contrast, patients with schizophrenia exhibit psychotic symptoms that occur in the absence of an identifiable mood disorder. A family history of schizophrenia among relatives is not associated with an increased risk of psychotic depression.[26] A few biological markers have been documented that distinguish psychotic depression from schizophrenia. Patients with psychotic depression and schizophrenia differ in hypothalamic-pituitary-adrenal axis activity and all-night sleep electroencephalogram readings.[1]