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Distinctive Clinical Correlates of Psychotic Major Depression: The CRESCEND Study

Authors
Park, Seon-CheolLee, Hwa-YoungSakong, Jeong-KyuJun, Tae-YounLee, Min-SooKim, Jae-MinKim, Jung-BumYim, Hyeon-WooPark, Yong Chon
Issue Date
7월-2014
Publisher
KOREAN NEUROPSYCHIATRIC ASSOC
Keywords
Psychotic major depression; Distinctive correlates; Diagnostic entity
Citation
PSYCHIATRY INVESTIGATION, v.11, no.3, pp.281 - 289
Indexed
SCIE
SSCI
SCOPUS
KCI
Journal Title
PSYCHIATRY INVESTIGATION
Volume
11
Number
3
Start Page
281
End Page
289
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/98158
DOI
10.4306/pi.2014.11.3.281
ISSN
1738-3684
Abstract
Objective The purpose of this investigation was to identify distinctive clinical correlates of psychotic major depression (PMD) as compared with non-psychotic major depression (NPMD) in a large cohort of Korean patients with major depressive disorder (MDD). Methods We recruited 966 MDD patients of age over 18 years from the Clinical Research Center for Depression of South Korea (CRESCEND) study. Diagnoses of PMD (n=24) and NPMD (n=942) were made with the DSM-IV definitions and confirmed with SCID. Psychometric scales were used to assess overall psychiatric symptoms (BPRS), depression (HAMD), anxiety (HAMA), global severity (CGI-S), suicidal ideation (SSI-Beck), functioning (SOFAS), and quality of life (WHOQOL-BREF). Using independent t-tests and chi(2) tests, we compared clinical characteristics of patients with PMD and NPMD. A binary logistic regression model was constructed to identify factors independently associated with increased likelihood of PMD. Results PMD subjects were characterized by a higher rate of inpatient enrollment, and higher scores on many items on BPRS (somatic concern, anxiety, emotional withdrawal, guilt feelings, tension, depression, suspiciousness, hallucination, motor retardation, blunted affect and excitement) global severity (CGI-s), and suicidal ideation (SSI-Beck). The explanatory factor model revealed that high levels of tension, excitement, and suicidal ideation were associated with increased likelihood of PMD. Conclusion Our findings partly support the view that PMD has its own distinctive clinical manifestation and course, and may be considered a diagnostic entity separate from NPMD.
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