Psychotic (delusional) major depression in late life: a clinical study.
BACKGROUND
Psychotic (delusional) major depression (PMD) in the elderly is a common condition in inpatient settings. There is evidence that late age onset depressives are more likely to be psychotic.


OBJECTIVE
The aim of this study was to investigate the frequency, sociodemographic, and clinical characteristics of PMD in hospitalized elderly depressives.


METHODS
The sample consisted of 118 elderly patients consecutively admitted at three different clinics. All patients fulfilled DSM-IV criteria for major depression disorder and were diagnosed on the basis of Structured Clinical Interview for DSM-IV (SCID). The subjects were also assessed using the Hamilton Rating Scale for Depression, the Mini Mental State Examination (MMSE) and a physical health rating scale.


RESULTS
PMD was positively associated with age of depression onset over 60 [corrected]. The PMD patients were also more severely depressed, more psychomotorically retarded and referred more past psychotic depressive episodes. Furthermore, age at onset influenced the type of delusions, so that PMD patients with age [corrected] over 60 at onset expressed delusions of hypochondriacal and nihilistic content more frequently.


CONCLUSIONS
The results of our study demonstrated that PMD in the elderly has a later age at onset.
Gournellis
R
R
Athens University Medical School, Department of Psychiatry, Clinical and Research Center of Affective Disorders, Eginition Hospital, Athens, Greece.
Lykouras
L
L
Fortos
A
A
Oulis
P
P
Roumbos
V
V
Christodoulou
G N
GN
D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D005852:Geriatric Psychiatry; D006304:Health Status; D006801:Humans; D008609:Mental Status Schedule; D008875:Middle Aged; D010343:Patient Admission; D012307:Risk Factors; D012563:Schizophrenia, Paranoid / Q000523:psychology*; D012720:Severity of Illness Index