Distinctive clinical correlates of psychotic major depression: The CRESCEND study

Seon Cheol Park, Hwa Young Lee, Jeong Kyu Sakong, Tae Youn Jun, Min-Soo Lee, Jae Min Kim, Jung Bum Kim, Hyeon Woo Yim, Yong Chon Park

    Research output: Contribution to journalArticlepeer-review

    17 Citations (Scopus)

    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 χ2 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.

    Original languageEnglish
    Pages (from-to)281-289
    Number of pages9
    JournalPsychiatry Investigation
    Volume11
    Issue number3
    DOIs
    Publication statusPublished - 2014 Jan 1

    Keywords

    • Diagnostic entity
    • Distinctive correlates
    • Psychotic major depression

    ASJC Scopus subject areas

    • Psychiatry and Mental health
    • Biological Psychiatry

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