Psychotic depression: An underappreciated window to explore the dimensionality and pathobiology of psychosis

摘要

In historical context, the classification and consideration of psychotic depression vis-a-vis schizophrenia and bipolar disorder has long been both unsatisfactory and contentious. Set against the backdrop of a continuum of depressed mood, from normal reaction to life events (eg, bereavement) through to severe depression with marked anhedonia, psychomotor retardation, and neurovegetative changes (so-called melancholia), we have struggled to understand the diversity of mood disorder. Furthermore, we have struggled to determine whether we can tease out distinct subgroups of etiological significance or, alternatively, whether in reality these reflect manifestations along a continuum of severity.