Psychotic Depression with Dr. Cummings

Psychiatry & Psychotherapy Podcast

David J Puder

Science, Health & Fitness, Medicine

4.8 • 1.3K Ratings

🗓️ 22 December 2023

⏱️ 83 minutes

🔗️ Recording | iTunes | RSS

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Summary

The underreporting of psychotic symptoms by patients in depression is a significant concern, frequently driven by the fear of consequences like hospitalization or the stigma of embarrassment.

We'll discuss the history, the differential to consider when thinking of psychotic depression, mechanisms, and treatment. Notably, individuals with psychotic depression face a suicide rate double that of their non-psychotic counterparts. A recent cohort study by Paljärvi in 2023 revealed a stark contrast: deaths due to suicide were 2.6% in the psychotic depression cohort, compared to 1% in the non-psychotic group. Alarmingly, most suicides occurred within the first two years following diagnosis. People who suffer from psychotic depression often do not report their psychotic symptoms, leading to inadequate response to normal depression treatments. With 6-25% of individuals with major depressive disorder (MDD) exhibiting psychotic features, it is imperative to understand and address these unique challenges. Join us as we unravel the complexities of this underrecognized aspect of mental health.

Transcript

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0:00.0	All right, welcome to the podcast.
0:14.8	I am joined today with Dr. Michael Cummings.
0:17.6	We'll be doing a deep dive on psychotic depression.
0:21.5	I want to give a shout out to Cara Jacobson and James Swanson, awesome students who helped
0:26.9	me with the write-up that is on psychiatrypodcast.com.
0:31.0	You know, for every single episode, we do a detailed write-up with citations giving you
0:37.1	more information than the actual episode contains.
0:41.1	And I wanted to introduce this topic.
0:43.8	We kind of jump around a little bit throughout the episode and I wanted to give you kind
0:48.8	of a big picture kind of where we're going.
0:51.6	Okay.
0:52.9	We talk about as the history of psychotic depression.
0:55.4	We talk about the differential and throughout the episode, we're talking about the differential
1:00.7	different types of issues that could look like depression with psychosis, but may actually
1:07.7	have an alternative diagnosis and alternative treatment.
1:12.0	For example, catatonia, you know, how do you differentiate catatonic depression, which
1:18.8	could have a psychotic, which could have some psychotic symptoms as well, from just
1:24.4	a psychotic depression?
1:25.6	How do you differentiate borderline personality disorder, which may have more dissociative
1:30.2	psychotic events from psychotic depression?
1:34.2	If they're bipolar with psychosis, they could have more mood, incongruent psychotic features,
1:41.4	meaning that they look depressed, but some of their psychotic thoughts are very grandiose
	...

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