This is a very distressing condition where people often describe feeling black and empty, unable to think or feel. Suicidal thinking is related to the profound feeling of despair and feeling of self-punishment.
If a patient is very agitated, assume psychosis. Those with psychotic depression usually don’t recover on an antidepressant alone.
Psychotic features: consistent with mood (mood congruent) or mood incongruent. Delusions more common than hallucinations (90% vs. 10%).
Some additional useful questions which can help to determine if a patient is suffering from psychotic depression include:
Page last updated: 16-Jan-2009
Depression and Bipolar Disorder Information Australia - Black Dog Institute.
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