Delusional and nondelusional unipolar depression: further evidence for distinct subtypes

Abstract

In a retrospective analysis, the course, symptoms, treatment response and personality of 54 delusional and 66 nondelusional unipolar depressed patients were compared. The delusional patients had more guilt feelings and were more ruminative, agitated and referential than the nondelusional patients. They had a poor response to tricyclic antidepressant therapy but good treatment outcome with a tricyclic-antipsychotic combination or ECT [electroconvulsive therapy]. The form and content of prior episodes were remarkably similar to the index episode in both groups. Findings support the conception of unipolar delusional depression as a distinct subtype of depressive illness.