Am J Psychiatry 1987; 144:1154-1160
Copyright © 1987 by American Psychiatric Association
The prognostic relevance of delusions in depression: a follow-up study
RL Kettering, M Harrow, L Grossman and HY Meltzer
To determine whether delusional depression has a different clinical course
from other types of depression, the authors followed up 31 unipolar
delusional depressed patients, 28 unipolar nonpsychotic depressed patients,
and 51 schizophrenic patients 14 months after hospital discharge. Patients
were assessed on 1) overall outcome, 2) psychotic, anxiety-neurotic, and
depressive symptoms, 3) social and work functioning, and 4)
rehospitalization. The delusional depressed patients showed significantly
more mood-incongruent delusions at follow- up. Surprisingly, the
nonpsychotic depressed patients exhibited more depressed mood and
significantly more anxiety at follow-up. The findings suggest that the
diagnostic distinction between delusional and nonpsychotic depression is
relevant to the clinical course of major depression.
