Browsing by Subject "oirekuva"

BACKGROUND: There are challenges in differentiating psychotic depression from bipolar disorder and schizophrenia, and it is thus meaningful to investigate the differences between these disorders. A substantial number of psychotic depression patients get a later diagnosis of bipolar disorder or schizophrenia. QUESTIONS: (1) What are the differences in clinical picture, clinical outcome and social functioning of psychotic depression when compared to bipolar disorder and schizophrenia? (2) Does the clinical picture differentiate between those whose diagnosis shifts to bipolar disorder or schizophrenia and those who retain their diagnosis of psychotic depression? RESULTS: Diagnostic judgement of psychotic depression differs from that of bipolar disorder and schizophrenia. The latter require longer follow-ups, whereas psychotic depression can be transitory. The clinical picture of psychotic depression patients whose diagnosis switched to bipolar disorder and schizophrenia resembled those disorders even at baseline. Those shifting from psychotic depression to bipolar disorder had more positive and fewer negative symptoms, whereas those shifting to schizophrenia had worse functioning and more psychotic symptoms. There were no significant differences between the clinical picture of psychotic depression and bipolar disorder. Schizophrenics, on the other hand, have more involuntary treatment and were more likely to harm others, when compared to patients of psychotic depression. Conversely, psychotic depression patients were more prone to deliberate self-harm and have physical health problems. Patients of psychotic depression have, overall, better social outcome than schizophrenics. Bipolar disorder patients seem to have higher education but more unemployment and worse social relationships than psychotic depression patients. All in all, the outcome of psychotic depression is much better than schizophrenia’s but does not significantly differ from that of bipolar disorder. CONCLUSIONS: It seems that challenges to differentiate psychotic depression from bipolar disorder and schizophrenia are linked to shorter follow-up. Though some differences may be observable even at baseline, differences in clinical picture, clinical outcome and social functioning become more evident in longer follow-up.