Major Depression With Psychotic Features – Causes, Symptoms, Tests, Treatment

Major depression with psychotic features

Major depression with psychotic features is a serious depression that is characterised by the hallucinations and loss of reality (psychosis).  Patient is not only depressed but also develops


Major depression causes profound effect on the lifestyle of affected patients who find it difficult to work, eat, sleep, concentrate and enjoy social activities.

Causes of Major Depression with Psychosis

The exact cause of Major Depression with Psychosis is not known. However there are certain risk factors that make a patient more vulnerable to this disease.

Risk factors that trigger Major depression with Psychosis in individuals

•             Individuals with family history of depression or psychotic illness

•             Individuals who have had traumatic childhood experiences

•             Individuals with family history of alcoholism

•             Individuals with biological family members who have had committed suicide

•             Individuals who have faced unfortunate life events like death of loved ones, divorce,

•             Individuals who have experienced major life changes such as job change, retirement

•             Individuals who have experienced physical, sexual, or emotional abuse

•             Individuals who have had failed personal relationships

•             Postpartum depression in women who have given birth to child recently

•             Individuals with low self-esteem and feelings of being deprived

•             Individuals who are addicted to alcohol, nicotine or illicit drugs

Symptoms of Major Depression with Psychosis

Patients who have Major Depression with Psychosis are characterised by the occurrence of major depressive episode lasting for entire day for at least two weeks. They also exhibit symptoms of psychosis.

•             Delusions involving false beliefs regarding one’s identity and locations

•             Hallucinations involving seeing or hearing unrealistic things

•             Depressed mood

•             Lack of interest in activities that were once pleasurable

•             Significant weight loss or weight gain

•             Difficulty in sleeping

•             Excessive movement or slowing down

•             Fatigue

•             Feeling of worthlessness or guilt

•             Difficulty in concentrating or making decisions

•             Suicidal thoughts

Patients usually exhibit the delusions and hallucinations associated with their depressed feelings.

Diagnostic Tests for Major Depression with Psychosis

The diagnosis of the major depression is performed by doctors after thorough medical examination of the depressed patient.  Patient is asked various questions related to medical history and symptoms.

Common Diagnostic Procedures

•             Full patient medical history

•             Physical Assessment

•             Thorough evaluation of symptoms

•             Standardized questionnaires like Hamilton Rating Scale for Depression, and the Beck Depression Inventory

•             Blood tests for TSH and thyroxin levels for excluding hypothyroidism

•             Basic electrolytes and serum calcium for ruling out metabolic disturbances

•             Full blood count including ESR for ruling out a systemic infection

•             Adverse affective reactions for medications

•             Adverse affective reactions for alcohol misuse

•             Evaluation of Testosterone levels for diagnosing hypogonadism

Treatment of Major Depression with Psychosis

Patients who have major depression with psychosis require immediate medical care and treatment.

There are various treatment therapies available for treating Major Depression. The doctors usually employ the combination of various therapies to obtain the optimal results

•             Medications like antidepressants and antipsychotic medication

•             Cognitive-behavioural therapy/ Psychotherapy

•             Physical exercise

•             Electroconvulsive therapy (ECT)

•             Vagus nerve stimulation

•             Tran cranial magnetic stimulation (TMS)

•             Lifestyle and home remedies

•             Herbal remedies and supplements

•             Mind-body connections

•             Coping and support