MIDAS Project
Publication Abstracts
Zimmerman, M., Mattia, J.I. Psychotic subtyping of major depressive
disorder and posttraumatic stress disorder. Journal of Clinical
Psychiatry, 2005, 60, 311-314.
Background: Many studies have established that a large
percentage of patients with posttraumatic stress disorder (PTSD) have
major depressive disorder (MDD). Other studies have found that patients
with PTSD or a history of childhood trauma have an increased rate of
psychotic symptoms. In the present report from the Rhode Island Methods to
Improve Diagnosis and Services (MIDAS) project we examined whether there
was an association between psychotic subtyping of MDD and PTSD. Method:
Five hundred psychiatric outpatients were interviewed with the
Structured Clinical Interview for DSM-IV (SCID). Results: Almost
half of the 500 patients had nonbipolar MDD (n=235, 47.0%), 45 (18.6%) of
whom had PTSD. Nineteen patients had psychotic depression, 216 had
nonpsychotic depression. Compared to patients with nonpsychotic
depression, the patients with psychotic depression were nearly four times
more likely to have PTSD (57.9% vs. 15.7%, Fisher's exact p=. 0001). Conclusion:
The results of the present study suggest that the presence of
psychosis in psychiatric outpatients with MDD is associated with
concurrent PTSD. It is hypothesized that that the poorer longitudinal
course of psychotic than nonpsychotic depression may be due to the
underrecognition of PTSD in psychotically depressed patients.
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