Show
Major depression with psychotic features, or psychotic depression, is an extremely serious mental health condition that can have significant consequences if left untreated. Sufferers experience the devastating lows of depression along with the frightening delusions and hallucinations of psychosis, and the symptoms this potent combination produces are highly debilitating. Nevertheless, with long-term treatment and a deep commitment to recovery, psychotic depression can be controlled and eventually overcome. Major depression is a serious mental health condition that disrupts functioning and can leave sufferers feeling helpless and overwhelmed by even the simplest tasks or responsibilities. Individuals with depression lose energy and motivation, and they experience feelings of emptiness and meaninglessness that won’t relent. As debilitating as the symptoms of clinical depression can be, the situation is even worse for people who suffer from a related condition known as psychotic depression, or major depression with psychotic features. People with this disorder experience the symptoms of depression and psychosis simultaneously, a potent and highly disabling mixture. When major depression is complicated by psychotic symptoms, professional assistance should be sought immediately. Unfortunately, because psychotic depression is still relatively unknown outside the mental health profession, few people suspect they or their family members may be suffering from its dangerous effects. What is Psychosis?Psychosis is a severe brain-related condition that causes sufferers to lose touch with reality. Their perceptions become distorted and their inner experiences no longer reflect the world as it actually is, and they may go through enormous emotional and psychological upheaval as they struggle to maintain healthy relationships and meet their personal and professional obligations. In the early stages of psychosis, family members and friends will likely notice only small changes in their loved ones’ behavior, such as:
As these symptoms intensify, individuals may eventually cross the line into full-blown psychosis, where hallucinations and delusions seriously interfere with their ability to function. These false sensory impressions and false beliefs often take on a sinister or threatening aspect, and they can cause sufferers to make bizarre statements or exhibit irrational and possibly hazardous behaviors. Others may very well be at risk because of these behaviors, and people experiencing psychotic episodes are certainly not safe and should not be left unsupervised until medical attention can be obtained. Psychosis is not in itself a true medical condition. Rather, it is a symptom of a deeper medical problem. It will not clear up on its own, and a period of hospitalization might be necessary when the symptoms of psychosis reach their peak intensity. Psychotic Depression Facts and StatisticsMajor depression is the most prevalent form of mental illness in the United States, and psychosis is a more common side effect of depression than most realize:
Advanced psychotic symptoms can occur in conjunction with depression, bipolar disorder (in the depressive or manic state), schizophrenia, or schizoaffective disorder, or as an occasional symptom of other conditions like dissociative identity disorder, PTSD, schizotypal personality disorder, and borderline personality disorder. In every instance it is a complication that will make the symptoms of the associated mental health disorder more serious and debilitating, making treatment an urgent priority. Signs and Symptoms of Major Depression with Psychotic FeaturesPsychotic features that accompany depression may produce mood-congruent or mood-incongruent symptoms. This means that the delusions and hallucinations experienced may either complement the negative mindsets associated with depression (mood-congruent) or contradict or counteract them (mood-incongruent) by convincing the sufferer that he or she is powerful, important, or invincible. Mood-incongruent psychosis seems to mimic the manic states of bipolar depression, while mood-congruent intensifies the sense of emptiness and desperation associated with major depression. The hallucinations experienced by people with psychotic depression may be audio (hearing voices), visual, touch- or smell-related, and are usually so lifelike that sufferers cannot tell the difference between imagination and reality. These hallucinations may be filled with ominous warnings and content and are often highly personalized and meaningful to the psychotic depression sufferer. Delusions can cover a wide variety of unusual or paranoid thoughts and beliefs, and they can easily motivate actions that are self-destructive or put others at risk. The symptoms of psychotic depression are nearly identical to those of conventional clinical depression. Common signs include:
Psychotic depression does produce a few additional symptoms that may not normally manifest in those with depression alone. Sufferers tend to experience more agitation and anxiety than people with conventional major depression, may worry constantly about their physical health, can experience escalating difficulties with thinking and memory, and at times may sit or lay in the same position for hours, without moving or speaking to anyone. When their delusions or hallucinations run out of control, people suffering from major depression with psychotic features may become completely disconnected from reality, and at that point emergency medical intervention is required. Psychotic Depression and the BrainAll forms of mental illness can be traced to brain abnormalities (both chemical and structural) that inhibit clear thinking and perception and cause overstimulation in neural centers that impact mood and behavior. In men and women with psychotic depression, weak or uncoordinated activity in the hypothalamic pituitary adrenal axis (HPA) appears to play an influential role in the onset of the condition. The HPA is a neurological feedback network that unites the hypothalamus and pituitary gland in the brain with the adrenal gland near the kidneys. When the system operates smoothly, it helps facilitate normal reactions to stress, boosts immune function, promotes a balanced mood, regulates emotional responses, and aids the process of digestion. However, medical studies indicate that dysfunctionality in the HPA is common among people with psychotic depression, which results in chronically elevated levels of the hormone cortisol, a potent chemical normally released in limited amounts in response to stress. Overabundance of cortisol indicates a high vulnerability to stress and anxiety, and that can ultimately leave a person vulnerable to depression and/or psychosis. Risk Factors for Psychotic DepressionThe established risk factors for major depression with psychotic features include:
Diagnosing Major Depression with Psychotic FeaturesSince most depression sufferers don’t exhibit psychotic symptoms, they can be easy for clinicians to miss if the patient doesn’t report them in detail. An excessive focus on either the symptoms of depression or the symptoms of psychosis can also lead to an incomplete diagnosis. But these types of errors are becoming increasingly rare. Awareness of the existence of psychotic depression has grown as research into the condition has progressed. To be diagnosed with psychotic depression, a patient must display multiple symptoms of depression for at least two weeks, and the distinctive symptoms of psychosis—namely, delusions and/or hallucinations—must also have been experienced during that time period. These standards are codified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which lists major depression with psychotic features as a subtype of major depression. Patients may be diagnosed with either mood-congruent or mood-incongruent psychotic depression, but this will not alter recommendations for treatment. Treatment and Long-Term RecoveryWhile aftercare will include outpatient services, treatment for psychotic depression should begin in a residential mental health facility that offers intensive inpatient programs for individuals with severe psychological or behavioral health issues. Before treatment can begin, a patient showing signs of psychosis should be thoroughly evaluated by a mental health professional (and possibly by a medical doctor as well) to determine if their symptoms are severe enough to require psychiatric hospitalization. Long-term inpatient treatment for psychotic depression will consist primarily of medication plus daily individual therapy sessions, with group and family sessions added as recovery progresses. Studies have confirmed that a combination of antidepressants and antipsychotic medications delivers the strongest healing effects for those who suffer from this disorder, although ECT (electroconvulsive or electroshock) therapy may occasionally be offered if the patient does not respond adequately to medication. Psychotic depression is a challenging condition to overcome. But there is great hope of eventual recovery for sufferers who begin treatment in an extended inpatient program, are truly dedicated to their healing process from initial treatment through aftercare, and have the full and unconditional support of family and friends at each stage of their recovery. What does major depressive disorder with psychotic features mean?Major depression with psychotic features is a mental disorder in which a person has depression along with loss of touch with reality (psychosis).
What is MDD recurrent severe with psychotic features?Major depressive disorder (MDD) with psychotic features is a distinct type of depressive illness in which mood disturbance is accompanied by either delusions, hallucinations, or both. Psychotic features occur in nearly 18.5% of patients who are diagnosed with MDD.
What is the ICD 10 code for major depressive disorder recurrent severe with psychotic features?3 Recurrent depressive disorder, current episode severe with psychotic symptoms. A disorder characterized by repeated episodes of depression, the current episode being severe with psychotic symptoms, as in F32.
What is considered recurrent on major depressive disorder?A recurrent depressive disorder is characterized by repeated episodes of depression without any history of independent episodes of mood elevation and increased energy or mania. There has been at least one previous episode lasting a minimum of two weeks and separated by the current episode of at least two months.
|