Phenomenology of psychotic mood disorders: Lifetime and major depressive episode features

Daniel Souery, Leonardo Zaninotto, Raffaella Calati*, Sylvie Linotte, Othman Sentissi, Daniela Amital, Ulrike Moser, Siegfried Kasper, Joseph Zohar, Julien Mendlewicz, Alessandro Serretti

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: The nosological and clinical implications of psychotic features in the course of mood disorders have been widely debated. Currently, no specification exists for defining a subgroup of lifetime Psychotic Mood Disorder (PMD) patients. Methods: A total of 2178 patients were examined, including subjects with Bipolar Disorder (BP) type I (n = 519) and II (n = 207) and Major Depressive Disorder (n = 1452). Patients were divided between PMD (n = 645) and non-psychotic Mood Disorders (MD) (n = 1533) by the lifetime presence of at least one mood episode with psychotic features. Subjects having a depressive episode at the time of assessment were also examined: HAM-D and YMRS scores were compared between MD and PMD subjects, both with and without current psychotic features. Results: A diagnosis of BP-I, a higher familial load for BP, a higher number of mood episodes lifetime, and a higher prevalence of OCD and somatic comorbidities were all associated to PMD. A diagnosis of BP (OR = 4.48) was the only significant predictor for psychosis. PMD with non-psychotic depression were apparently less severe than MD patients and had a lower rate of "non-responders" to AD treatment. Sub-threshold manic symptoms and suicidal risk were also more pronounced among PMD. Limitations: The lack of information about number and polarity of previous psychotic mood episodes may be the major limitations of our study. Conclusions: BP diagnosis is the most significant predictor for psychosis in mood disorders. Non-psychotic mood episodes in PMD patients may be characterized by a distinctive symptom profile and, possibly, a different response to treatment.

Original languageEnglish
Pages (from-to)241-250
Number of pages10
JournalJournal of Affective Disorders
Issue number1-3
StatePublished - Dec 2011
Externally publishedYes


FundersFunder number
National Found for Scientific Research
Institut national de la recherche scientifique3.4553.01


    • Bipolar
    • Major depression
    • Mood disorders
    • Psychosis
    • Unipolar


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