What is psychotic depression?

by | Oct 18, 2022 | Curbside Consults

Q. Is psychotic depression yet another form of depression? Or is psychotic depression the same as manic depression? What is the difference between the two? I know that depression is qualified as neurosis and manic depression as psychosis. What about psychotic depression then? Or is psychotic depression just another term for depression still?
PL. This answer is too brief to be definitive, but it will get the idea across. “I know that depression is qualified as neurosis and manic depression as psychosis.” This is not true. The two phrases neurosis and psychosis are misleading and not helpful. Psychosis scientifically (not in various theories) just means presence of delusions or hallucinations. You can have depression with delusions or hallucinations, or you can have depression without delusions or hallucinations. They both happen in MDI. It doesn’t change the diagnosis at all. It’s not important diagnostically – the same as saying you can have pneumonia with fever or pneumonia without fever. It can affect treatment – antipsychotics generally are need for “psychotic” depression, which just means the above, but not for non-psychotic depression. Just as you need aspirin for fever but not when there is no fever. In either case, the diagnosis is the same and antibiotics are still needed. “Psychotic depression” set up as a separate “disorder”: Another misleading error of DSM.