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Am J Psychiatry 1996; 153:490-496
Copyright © 1996 by American Psychiatric Association
Clinical and neuropsychological comparison of psychotic depression with nonpsychotic depression and schizophrenia
DV Jeste, SC Heaton, JS Paulsen, L Ercoli, J Harris and RK Heaton
Department of Psychiatry, University of California, San Diego, USA.
OBJECTIVE: This study compared the clinical and neuropsychological
characteristics of patients with psychotic depression to those of patients
with nonpsychotic depression and patients with schizophrenia. METHOD: Two
hundred eighteen patients over the age of 45, including 30 who met the
DSM-III-R criteria for unipolar major depression with psychotic features,
28 with nonpsychotic unipolar major depression, and 160 with schizophrenia,
were examined. Subjects were evaluated on several clinical measures as well
as on neuropsychological tests of attention, learning, memory (retention),
psychomotor speed, and motor skills. RESULTS: The three groups were
comparable in age and education. The severity of depressive symptoms in the
depressed patients with and without psychosis was similar. The patients
with psychotic depression were comparable to those with schizophrenia on
the neuropsychological measures; they were more impaired than the patients
with nonpsychotic depression on the measures of psychomotor speed, motor
skills, attention, and learning. The cognitive deficits seemed to be trait-
related. CONCLUSIONS: The findings provide additional support for the
validity of psychotic depression as a diagnostic category distinct from
nonpsychotic depression.
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