Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-23T00:22:38.044Z Has data issue: false hasContentIssue false
  • English
  • Français

Epidemiology of psychotic depression – systematic review and meta-analysis

Published online by Cambridge University Press:  12 September 2017

E. Jääskeläinen ,
T. Juola ,
H. Korpela ,
H. Lehtiniemi ,
M. Nietola ,
J. Korkeila  and
J. Miettunen
E. Jääskeläinen*
Affiliation:
Center for Life Course Health Research, University of Oulu, Finland Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland Department of Psychiatry, Oulu University Hospital, Finland
T. Juola
Affiliation:
Center for Life Course Health Research, University of Oulu, Finland
H. Korpela
Affiliation:
Center for Life Course Health Research, University of Oulu, Finland Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
H. Lehtiniemi
Affiliation:
Center for Life Course Health Research, University of Oulu, Finland
M. Nietola
Affiliation:
Psychiatric Department, University of Turku and Turku University Hospital, Finland
J. Korkeila
Affiliation:
Psychiatric Department, University of Turku and Satakunta Hospital District, Finland
J. Miettunen
Affiliation:
Center for Life Course Health Research, University of Oulu, Finland Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
*
*Address for correspondence: E. Jääskeläinen, Center for Life Course Health Research, P.O. Box 5000, University of Oulu, Oulu 90014, Finland. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Large amount of data have been published on non-psychotic depression (NPD), schizophrenia (SZ), and bipolar disorder, while psychotic depression (PD) as an own entity has received much smaller attention. We performed a systematic review and meta-analyses on epidemiology, especially incidence and prevalence, risk factors, and outcomes of PD. A systematic search to identify potentially relevant studies was conducted using four electronic databases and a manual search. The search identified 1764 unique potentially relevant articles, the final study included 99 articles. We found that the lifetime prevalence of PD varies between 0.35% and 1%, with higher rates in older age. Onset age of PD was earlier than that of NPD in younger samples, but later in older samples. There were no differences in gender distribution in PD v. NPD, but higher proportion of females was found in PD than in SZ or in psychotic bipolar disorder (PBD). Risk factors have rarely been studied, the main finding being that family history of psychosis and bipolar disorder increases the risk of PD. Outcomes of PD were mostly worse when compared with NPD, but better compared with SZ and schizoaffective disorder. The outcome compared with PBD was relatively similar, and somewhat varied depending on the measure of the outcome. Based on this review, the amount of research on PD is far from that of NPD, SZ, and bipolar disorder. Based on our findings, PD seems distinguishable from related disorders and needs more scientific attention.

Keywords

Epidemiologyincidencemajor depressive disorderoutcomeprognosispsychosispsychotic depressionpsychotic disordersriskunipolar depression
Type
Review Article
Information
Psychological Medicine , Volume 48 , Issue 6 , April 2018 , pp. 905 - 918
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

†

These authors contributed equally to this work.

References

American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5. American Psychiatric Publishing: Arlington, VA.Google Scholar
Baldwin, RC (1988). Delusional and non-delusional depression in late life. Evidence for distinct subtypes. British Journal of Psychiatry 152, 39–44.Google Scholar
Baldwin, RC (1995). Delusional depression in elderly patients: characteristics and relationship to age at onset. International Journal of Geriatric Psychiatry 10, 981–985.CrossRefGoogle Scholar
Baldwin, P, Browne, D, Scully, PJ, Quinn, JF, Morgan, MG, Kinsella, A, Owens, JM, Russell, V, O'Callaghan, E, Waddington, JL (2005). Epidemiology of first-episode psychosis: illustrating the challenges across diagnostic boundaries through the Cavan-Monaghan study at 8 years. Schizophrenia Bulletin 31, 624–638.CrossRefGoogle Scholar
Benazzi, F (2007). Bipolar II disorder: epidemiology, diagnosis and management. CNS Drugs 21, 727–740.CrossRefGoogle ScholarPubMed
Breslau, N, Meltzer, HY (1988). Validity of subtyping psychotic depression: examination of phenomenology and demographic characteristics. The American Journal of Psychiatry 145, 35–40.Google ScholarPubMed
Bromet, EJ, Kotov, R, Fochtmann, LJ, Carlson, GA, Tanenberg-Karant, M, Ruggero, C, Chang, SW (2011). Diagnostic shifts during the decade following first admission for psychosis. The American Journal of Psychiatry 168, 1186–1194.Google Scholar
Buoli, M, Caldiroli, A, Altamura, AC (2013). Psychotic versus non-psychotic major depressive disorder: a comparative naturalistic study. Asian Journal of Psychiatry 6, 333–337.Google Scholar
Busatto, GF (2013). Structural and functional neuroimaging studies in major depressive disorder with psychotic features: a critical review. Schizophrenia Bulletin 39, 776–786.Google Scholar
Cohen, J (1992). A power primer. Psychological Bulletin 112, 155–159.CrossRefGoogle ScholarPubMed
Copeland, JR (1983). Psychotic and neurotic depression: discriminant function analysis and five-year outcome. Psychological Medicine 13, 373–383.CrossRefGoogle ScholarPubMed
Coryell, W, Keller, M, Lavori, P, Endicott, J (1990). Affective syndromes, psychotic features, and prognosis. I. Depression. Archives of General Psychiatry 47, 651–657.CrossRefGoogle ScholarPubMed
Coryell, W, Lavori, P, Endicott, J, Keller, M, VanEerdewegh, M (1984). Outcome in schizoaffective, psychotic, and nonpsychotic depression. Course during a six- to 24-month follow-up. Archives of General Psychiatry 41, 787–791.CrossRefGoogle Scholar
Coryell, W, Tsuang, MT (1985). Major depression with mood-congruent or mood-incongruent psychotic features: outcome after 40 years. The American Journal of Psychiatry 142, 479–482.Google Scholar
Coryell, W, Tsuang, MT, McDaniel, J (1982). Psychotic features in major depression. Is mood congruence important? Journal of Affective Disorders 4, 227–236.CrossRefGoogle ScholarPubMed
Craig, TJ, Bromet, EJ, Fennig, S, Tanenberg-Karant, M, Lavelle, J, Galambos, N (2000). Is there an association between duration of untreated psychosis and 24-month clinical outcome in a first-admission series?. American Journal of Psychiatry 157, 60–66.Google Scholar
Crebbin, K, Mitford, E, Paxton, R, Turkington, D (2008). Firstepisode psychosis: an epidemiological survey comparing psychotic depression with schizophrenia. Journal of Affective Disorders 105, 117–124.CrossRefGoogle ScholarPubMed
Čulav-Sumić, J, Jukić, V (2010). Minor physical anomalies in women with recurrent unipolar depression. Psychiatry Research 176, 22–25.Google Scholar
Dell'Osso, L, Pini, S, Cassano, GB, Mastrocinque, C, Seckinger, RA, Saettoni, M, Papasogli, A, Yale, SA, Amador, XF (2002). Insight into illness in patients with mania, mixed mania, bipolar depression and major depression with psychotic features. Bipolar Disorders 4, 315–322.CrossRefGoogle ScholarPubMed
Domschke, K (2013). Clinical and molecular genetics of psychotic depression. Schizophrenia Bulletin 39, 766–775.Google Scholar
Draper, B, Anstey, K (1996). Psychosocial stressors, physical illness and the spectrum of depression in elderly inpatients. The Australian and New Zealand Journal of Psychiatry 30, 567–572.CrossRefGoogle ScholarPubMed
Esan, O, Esan, A (2016). Epidemiology and burden of bipolar disorder in Africa: a systematic review of data from Africa. Social Psychiatry and Psychiatric Epidemiology 51, 93–100.Google Scholar
Farquhar, F, Le Noury, J, Tschinkel, S, Harris, M, Kurien, R, Healy, D (2007). The incidence and prevalence of manic-melancholic syndromes in North West Wales: 1875–2005. Acta Psychiatrica Scandinavica 115(suplementum), 37–43.CrossRefGoogle Scholar
Filatova, S, Marttila, R, Koivumaa-Honkanen, H, Nordström, T, Veijola, J, Mäki, P, Khandaker, GM, Isohanni, M, Jääskeläinen, E, Moilanen, K, Miettunen, J (2017). A comparison of the cumulative incidence and early risk factors for psychotic disorder in young adults in the Northern Finland Birth Cohorts 1966 and 1986. Epidemiology and Psychiatric Sciences 26, 314–324.Google Scholar
Fleming, SK, Blasey, C, Schatzberg, AF (2004). Neuropsychological correlates of psychotic features in major depressive disorders: a review and meta-analysis. Journal of Psychiatric Research 38, 27–35.Google Scholar
Frangos, E, Athanassenas, G, Tsitourides, S, Psilolignos, P, Katsanou, N (1983). Psychotic depressive disorder. A separate entity? Journal of Affective Disorders 5, 259–265.Google Scholar
Gaudiano, BA, Dalrymple, KL, Zimmerman, M (2009). Prevalence and clinical characteristics of psychotic versus nonpsychotic major depression in a general psychiatric outpatient clinic. Depression and Anxiety 26, 54–64.Google Scholar
Gaudiano, BA, Weinstock, LM, Epstein-Lubow, G, Uebelacker, LA, Miller, IW (2016). Clinical characteristics and medication use patterns among hospitalized patients admitted with psychotic vs nonpsychotic major depressive disorder. Annals of Clinical Psychiatry 28, 56–63.Google ScholarPubMed
Gaudiano, BA, Zimmerman, M (2010). The relationship between childhood trauma history and the psychotic subtype of major depression. Acta Psychiatrica Scandinavica 121, 462–470.Google Scholar
Goldberg, JF, Harrow, M (2005). Subjective life satisfaction and objective functional outcome in bipolar and unipolar mood disorders: a longitudinal analysis. Journal of Affective Disorders 89, 79–89.Google Scholar
Goodwin, FK, Jamison, KR (2007). Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression. Oxford University Press: New York.Google Scholar
Gournellis, R, Lykouras, L (2006). Psychotic (delusional) major depression in the elderly: a review. Current Psychiatry Reviews 2, 235–244.Google Scholar
Gournellis, R, Oulis, P, Howard, R (2014). Psychotic major depression in older people: a systematic review. Internatinal Journal of Geriatric Psychiatry 29, 789–796.Google ScholarPubMed
Haley, GM, Fine, S, Marriage, K (1988). Psychotic features in adolescents with major depression. Journal of the American Academy of Child & Adolescent Psychiatry 27, 489–493.Google Scholar
Heslin, M, Desai, R, Lappin, JM, Donoghue, K, Lomas, B, Reininghaus, U, Onyejiaka, A, Croudace, T, Jones, PB, Murray, RM, Fearon, P, Doody, GA, Dazzan, P, Fisher, HL, Demjaha, A, Craig, T, Morgan, C (2016 a). Biological and psychosocial risk factors for psychotic major depression. Social Psychiatry and Psychiatric Epidemiology 51, 233–245.Google Scholar
Heslin, M, Lappin, JM, Donoghue, K, Lomas, B, Reininghaus, U, Onyejiaka, A, Croudace, T, Jones, PB, Murray, RM, Fearon, P, Doody, GA, Dazzan, P, Craig, TJ, Morgan, C (2016 b). Ten-year outcomes in first episode psychotic major depression patients compared with schizophrenia and bipolar patients. Schizophrenia Research 176, 417–422.CrossRefGoogle ScholarPubMed
Heslin, M, Lomas, B, Lappin, JM, Donoghue, K, Reininghaus, U, Onyejiaka, A, Croudace, T, Jones, PB, Murray, RM, Fearon, P, Dazzan, P, Morgan, C, Doody, GA (2015). Diagnostic change 10 years after a first episode of psychosis. Psychological Medicine 45, 2757–2769.CrossRefGoogle ScholarPubMed
Higgins, JP, Thompson, SG, Deeks, JJ, Altman, DG (2003). Measuring inconsistency in meta-analyses. British Medical Journal 327, 557–560.Google Scholar
Hirschfeld, RM (2012). The epidemiology of depression and the evolution of treatment. Journal of Clinical Psychiatry 73(Suppl 1), 5–9.CrossRefGoogle ScholarPubMed
Ihezue, UH (1985). Observations and comments on the psychosocial determinants of depressive illness among Nigerian adults. Journal of the National Medical Association 77, 729–733.Google Scholar
Jäger, M, Bottlender, R, Strauss, A, Möller, HJ (2005). Fifteen-year follow-up of diagnostic and statistical manual of mental disorders, fourth edition depressive disorders: the prognostic significance of psychotic features. Comprehensive Psychiatry 46, 322–327.CrossRefGoogle ScholarPubMed
Jarbin, H, Ott, Y, Von Knorring, AL (2003). Adult outcome of social function in adolescent-onset schizophrenia and affective psychosis. Journal of the American Academy of Child and Adolescent Psychiatry 42, 176–183.Google Scholar
Johnson, J, Horwath, E, Weissman, MM (1991). The validity of major depression with psychotic features based on a community study. Archives of General Psychiatry 48, 1075–1081.CrossRefGoogle ScholarPubMed
Käkelä, J, Panula, J, Oinas, E, Hirvonen, N, Jääskeläinen, E, Miettunen, J (2014). Family history of psychosis and social, occupational and global outcome in schizophrenia: a meta-analysis. Acta Psychiatrica Scandinavica 130, 269–278.CrossRefGoogle ScholarPubMed
Karaaslan, F, Gonul, AS, Oguz, A, Erdinc, E, Esel, E (2003). P300 changes in major depressive disorders with and without psychotic features. Journal of Affective Disorders 73, 283–287.CrossRefGoogle ScholarPubMed
Keller, J, Schatzberg, AF, Maj, M (2007). Current issues in the classification of psychotic major depression. Schizophrenia Bulletin 33, 877–885.Google Scholar
Kessler, RC, Bromet, EJ (2013). The epidemiology of depression across cultures. The Annual Review of Public Health 34, 119–138.Google Scholar
Kivelä, SL, Pahkala, K (1989). Delusional depression in the elderly: a community study. Zeitschrift fur Gerontologie 22, 236–241.Google Scholar
Kruijshaar, ME, Hoeymans, N, Bijl, RV, Spijker, J, Essink-Bot, ML (2003). Levels of disability in major depression: findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Journal of Affective Disorders 77, 53–64.CrossRefGoogle ScholarPubMed
Leadholm, AK, Rothschild, AJ, Nolen, WA, Bech, P, Munk-Jørgensen, P, Ostergaard, SD (2013). The treatment of psychotic depression: is there consensus among guidelines and psychiatrists? Journal of Affective Disorders 145, 214–220.CrossRefGoogle ScholarPubMed
Lykouras, L, Gournellis, R (2009). Psychotic (delusional) major depression: new vistas. Current Psychiatry Reviews 5, 1–28.Google Scholar
Maj, M, Pirozzi, R, Magliano, L, Fiorillo, A, Bartoli, L (2007). Phenomenology and prognostic significance of delusions in major depressive disorder: a 10-year prospective follow-up study. The Journal of Clinical Psychiatry 68, 1411–1417.Google Scholar
Matheson, SL, Shepherd, AM, Carr, VJ (2014). How much do we know about schizophrenia and how well do we know it? Evidence from the Schizophrenia Library. Psychological Medicine 20, 1–19.Google Scholar
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG, PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine 6, e1000097.Google Scholar
Nakamura, K, Iga, J, Matsumoto, N, Ohmori, T (2015). Risk of bipolar disorder and psychotic features in patients initially hospitalised with severe depression. Acta Neuropsychiatrica 27, 113–118.Google Scholar
Nelson, JC, Davis, JM (1997). DST studies in psychotic depression: a meta-analysis. The American Journal of Psychiatry 154, 1497–1503.Google Scholar
Ohayon, MM, Schatzberg, AF (2002). Prevalence of depressive episodes with psychotic features in the general population. The American Journal of Psychiatry 159, 1855–1861.CrossRefGoogle ScholarPubMed
Okulate, GT, Oladapo, HT, Osibogun, A (2001). Comparison of three subtypes of depression. The Nigerian Postgraduate Medical Journal 8, 41–45.Google Scholar
Olesen, J, Gustavsson, A, Svensson, M, Wittchen, HU, Jönsson, B, CDBE2010 Study Group; European Brain Council (2012). The economic cost of brain disorders in Europe. European Journal of Neurology 19, 155–162.Google Scholar
Opjordsmoen, S (1991). Unipolar delusional depression. Outcome in reactive versus endogenous types. Psychopathology 24, 260–269.Google Scholar
Ormel, J, Oldehinkel, AJ, Nolen, WA, Vollebergh, W (2004). Psychosocial disability before, during, and after a major depressive episode: a 3-wave population-based study of state, scar, and trait effects. Archives of General Psychiatry 61, 387–392.Google Scholar
Østergaard, SD, Straszek, S, Petrides, G, Skadhede, S, Jensen, SO, Munk-Jørgensen, P, Nielsen, J (2014). Risk factors for conversion from unipolar psychotic depression to bipolar disorder. Bipolar Disorders 16, 180–189.Google Scholar
Østergaard, SD, Waltoft, BL, Mortensen, PB, Mors, O (2013). Environmental and familial risk factors for psychotic and non-psychotic severe depression. Journal of Affective Disorders 147, 232–240.CrossRefGoogle ScholarPubMed
Park, SC, Choi, J, Kim, JM, Jun, TY, Lee, MS, Kim, JB, Yim, HW, Park, YC (2014). Is the psychotic depression assessment scale a useful diagnostic tool? The CRESCEND study. Journal of Affective Disorders 166, 79–85.Google Scholar
Parker, G, Hadzi-Pavlovic, D, Hickie, I, Mitchell, P, Wilhelm, K, Brodaty, H, Boyce, P, Eyers, K, Pedic, F (1991). Psychotic depression: a review and clinical experience. The Australian and New Zealand Journal of Psychiatry 25, 169–180.Google Scholar
Penttilä, M, Jääskeläinen, E, Hirvonen, N, Isohanni, M, Miettunen, J (2014). Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis. British Journal of Psychiatry 205, 88–94.Google Scholar
Perälä, J, Suvisaari, J, Saarni, SI, Kuoppasalmi, K, Isometsä, E, Pirkola, S, Partonen, T, Tuulio-Henriksson, A, Hintikka, J, Kieseppä, T, Härkänen, T, Koskinen, S, Lönnqvist, J (2007). Lifetime prevalence of psychotic and bipolar I disorders in a general population. Archives of General Psychiatry 64, 19–28.CrossRefGoogle ScholarPubMed
Reay, R, Mitford, E, McCabe, K, Paxton, R, Turkington, D (2010). Incidence and diagnostic diversity in first-episode psychosis. Acta Psychiatrica Scandinavica 121, 315–319.Google Scholar
Rothschild, AJ (2009). Clinical Manual for Diagnosis and Treatment of Psychotic Depression. American Psychiatric Publishing Inc.: Washington, DC.Google Scholar
Rothschild, AJ, Winer, J, Flint, AJ, Mulsant, BH, Whyte, EM, Heo, M, Fratoni, S, Gabriele, M, Kasapinovic, S, Meyers, BS (2008). Study of Pharmacotherapy of Psychotic Depression (STOP-PD) Collaborative Study Group. Missed diagnosis of psychotic depression at 4 academic medical centers. Journal of Clinical Psychiatry 69, 1293–1296.CrossRefGoogle Scholar
Ruggero, CJ, Kotov, R, Carlson, GA, Tanenberg-Karant, M, Gonzalez, DA, Bromet, EJ (2011). Diagnostic consistency of major depression with psychosis across 10 years. The Journal of Clinical Psychiatry 72, 1207–1213.CrossRefGoogle Scholar
Rush, AJ, Carmody, TJ, Ibrahim, HM, Trivedi, MH, Biggs, MM, Shores-Wilson, K, Crismon, ML, Toprac, MG, Kashner, TM (2006). Comparison of self-report and clinician ratings on two inventories of depressive symptomatology. Psychiatric Services 57, 829–837.Google Scholar
Ryan, ND, Puig-Antich, J, Ambrosini, P, Rabinovich, H, Robinson, D, Nelson, B, Iyengar, S, Twomey, J (1987). The clinical picture of major depression in children and adolescents. Archives of General Psychiatry 44, 854–861.Google Scholar
Saarni, SI, Viertio, S, Perälä, J, Koskinen, S, Lönnqvist, J, Suvisaari, J (2010). Quality of life of people with schizophrenia, bipolar disorder and other psychotic disorders. The British Journal of Psychiatry 197, 386–394.Google Scholar
Salvatore, P, Baldessarini, RJ, Tohen, M, Khalsa, HM, Sanchez-Toledo, JP, Zarate, CA Jr., Vieta, E, Maggini, C (2011). McLean-Harvard International First-Episode Project: two-year stability of ICD-10 diagnoses in 500 first-episode psychotic disorder patients. The Journal of Clinical Psychiatry 72, 183–193.Google Scholar
Sands, JR, Harrow, M (1995). Vulnerability to psychosis in unipolar major depression: is premorbid functioning involved? The American Journal of Psychiatry 152, 1009–1015.Google Scholar
Schatzberg, AF, Rothschild, AJ (1992). Psychotic (delusional) major depression: should it be included as a distinct syndrome in DSM-IV? The American Journal of Psychiatry 149, 733–745.Google Scholar
Sherazi, R, McKeon, P, McDonough, M, Daly, I, Kennedy, N (2006). What's new? The clinical epidemiology of bipolar I disorder. Harvard Review of Psychiatry 14, 273–284.Google Scholar
Simpson, S, Baldwin, RC, Jackson, A, Burns, A (1999). The differentiation of DSM-III-R psychotic depression in later life from nonpsychotic depression: comparisons of brain changes measured by multispectral analysis of magnetic resonance brain images, neuropsychological findings, and clinical features. Biological Psychiatry 45, 193–204.Google Scholar
Souery, D, Zaninotto, L, Calati, R, Linotte, S, Sentissi, O, Amital, D, Moser, U, Kasper, S, Zohar, J, Mendlewicz, J, Serretti, A (2011). Phenomenology of psychotic mood disorders: lifetime and major depressive episode features. Journal of Affective Disorders 135, 241–250.Google Scholar
StataCorp (2013). Stata Statistical Software: Release 13. StataCorp LP: College Station.Google Scholar
Sterne, J (2009). Meta-Analysis in Stata: An Updated Collection From the Stata Journal. College Station: Stata Press.Google Scholar
Suvisaari, J, Partti, K, Perälä, J, Viertio, S, Saarni, SE, Lönnqvist, J, Saarni, SI, Härkänen, T (2013). Mortality and its determinants in people with psychotic disorder. Psychosomatic Medicine 75, 60–67.Google Scholar
Tohen, M, Khalsa, HM, Salvatore, P, Vieta, E, Ravichandran, C, Baldessarini, RJ (2012). Two-year outcomes in first-episode psychotic depression the McLean-Harvard First-Episode Project. Journal of Affective Disorders 136, 1–8.Google Scholar
Tohen, M, Strakowski, SM, Zarate, C Jr., Hennen, J, Stoll, AL, Suppes, T, Faedda, GL, Cohen, BM, Gebre-Medhin, P, Baldessarini, RJ (2000). The McLean-Harvard first-episode project: 6-month symptomatic and functional outcome in affective and nonaffective psychosis. Biological Psychiatry 48, 467–476.Google Scholar
Vythilingam, M, Chen, J, Bremner, JD, Mazure, CM, Maciejewski, PK, Nelson, JC (2003). Psychotic depression and mortality. The American Journal of Psychiatry 160, 574–576.Google Scholar
WHO (1992). International Classification of Diseases and Related Health Problems, 10th revision. World Health Organization: Geneva.Google Scholar
Wijkstra, J, Lijmer, J, Burger, H, Cipriani, A, Geddes, J, Nolen, WA (2015). Pharmacological treatment for psychotic depression. The Cochrane Database of Systematic Reviews 7, CD004044.Google Scholar
Zalpuri, I, Rothschild, AJ (2016). Does psychosis increase the risk of suicide in patients with major depression? A systematic review. Journal of Affective Disorders 198, 23–31.Google Scholar
Zaninotto, L, Guglielmo, R, Calati, R, Ioime, L, Camardese, G, Janiri, L, Bria, P, Serretti, A (2015). Cognitive markers of psychotic unipolar depression: a meta-analytic study. Journal of Affective Disorders 174, 580–588.Google Scholar
Supplementary material: File

Jääskeläinen et al supplementary material

Jääskeläinen et al supplementary material 1

Download Jääskeläinen et al supplementary material(File)
File 2 MB