title: Symptom Profile and Severity in a Sample of Nigerians with Psychotic versus Nonpsychotic Major Depression.
abstract: The therapeutic strategies in managing patients with psychotic major depression (PMD) differ from those with non-psychotic major depression (NMD), because of differences in clinical profile and outcome. However, there is underrecognition of psychotic symptoms in depressed patients. Previous studies in Western population suggest that certain symptom patterns, apart from psychosis which may be concealed, can facilitate the discrimination of PMD from NMD. These studies may have limited applicability to sub-Saharan Africa due to cross-cultural differences in the phenomenology of depression. This study compared the rates and severity of depressive symptoms in outpatients with PMD (n = 129) and NMD (n = 117) using the Structured Clinical Interview for Depression (SCID) and Hamilton Depression Rating Scale (HAM-D). Patients with PMD had statistically significantly higher rates of suicidal ideation, suicidal attempt, psychomotor agitation, insomnia, and reduced appetite. Patients with NMD were more likely to manifest psychomotor retardation and somatic symptoms. PMD was associated with greater symptom severity. On logistic regression analysis, suicidal ideation, psychomotor disturbances, insomnia, and somatic symptoms were predictive of diagnostic status. The presence of these symptoms clusters may increase the suspicion of occult psychosis in patients with depression, thereby informing appropriate intervention strategies.
authors.affiliation: Federal Neuropsychiatric Hospital, Yaba, 8 Harvey Road, PMB 2008, Lagos, Nigeria.
authors.forename: Increase Ibukun
authors.initials: II
authors.lastname: Adeosun
authors.forename: Oyetayo
authors.initials: O
authors.lastname: Jeje
references.citation: Arch Gen Psychiatry. 2005 Jun;62(6):617-27
references.pmid: 15939839
references.citation: Am J Psychiatry. 2002 Nov;159(11):1855-61
references.pmid: 12411219
references.citation: J Nerv Ment Dis. 1984 Sep;172(9):521-8
references.pmid: 6470694
references.citation: Br J Soc Clin Psychol. 1967 Dec;6(4):278-96
references.pmid: 6080235
references.citation: Compr Psychiatry. 2008 Sep-Oct;49(5):421-9
references.pmid: 18702928
references.citation: Am J Psychiatry. 1996 Apr;153(4):490-6
references.pmid: 8599396
references.citation: J Affect Disord. 2011 Dec;135(1-3):241-50
references.pmid: 21889213
references.citation: Niger Postgrad Med J. 2002 Jun;9(2):74-8
references.pmid: 12163877
references.citation: Acta Psychiatr Scand. 1989 Nov;80(5):474-8
references.pmid: 2596346
references.citation: J Affect Disord. 1991 Jul;22(3):135-48
references.pmid: 1918657
references.citation: J Affect Disord. 2009 Apr;114(1-3):103-9
references.pmid: 18687472
references.citation: J Nerv Ment Dis. 2005 Sep;193(9):625-8
references.pmid: 16131946
references.citation: Acta Psychiatr Scand. 1986 Mar;73(3):324-9
references.pmid: 2872774
references.citation: Ethn Dis. 2003 Fall;13(4):499-512
references.pmid: 14632270
references.citation: Am J Psychiatry. 2000 Jul;157(7):1095-100
references.pmid: 10873917
references.citation: Psychopathology. 2000 Nov-Dec;33(6):314-23
references.pmid: 11060516
references.citation: Schizophr Bull. 2007 Jul;33(4):877-85
references.pmid: 17548842
references.citation: Am J Psychiatry. 2003 Mar;160(3):574-6
references.pmid: 12611843
references.citation: Br J Psychiatry. 2004 May;184:422-7
references.pmid: 15123506
references.citation: Compr Psychiatry. 1988 Jan-Feb;29(1):12-21
references.pmid: 2893689
references.citation: Curr Psychiatry Rep. 2008 Jun;10(3):223-8
references.pmid: 18652790
references.citation: Niger Postgrad Med J. 2001 Mar;8(1):41-5
references.pmid: 11487783
references.citation: J Affect Disord. 1999 Jul;54(1-2):183-7
references.pmid: 10403162
references.citation: Biol Psychiatry. 2003 Apr 15;53(8):680-90
references.pmid: 12706954
references.citation: Acta Psychiatr Scand. 1987 Mar;75(3):231-6
references.pmid: 3591404
references.citation: Psychopathology. 2002 Jul-Aug;35(4):210-9
references.pmid: 12239437
references.citation: Cult Med Psychiatry. 1982 Mar;6(1):29-43
references.pmid: 7105787
references.citation: Br J Psychiatry. 1975 Dec;127:559-63
references.pmid: 1201449
references.citation: Psychiatry Res. 1999 May 31;86(2):99-106
references.pmid: 10397412