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Major depression with mood-congruent or mood-incongruent psychotic features: outcome after 40 years

Published Online:https://doi.org/10.1176/ajp.142.4.479

Using cross-sectional evaluations 40 years after index admissions, the authors compared depressed patients with mood-congruent and those with mood-incongruent psychotic features. These patients were then compared with patients with nonpsychotic major depression, schizophreniform disorder, or schizophrenia. Outcome in the mood-congruent group resembled that in the nonpsychotic group and was significantly better than that in the mood-incongruent group. Patients in this latter group, however, had significantly better follow-up scores than did schizophrenic patients. These findings are consistent with a short-term outcome and family history study and suggest that patients with major depression and mood-incongruent psychotic features constitute a more diagnostically heterogeneous group than do those with mood-congruent psychotic features.

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