ABSTRACT
INTRODUCTION Psychotic depression (major depression with psychotic features, delusional depression) is a serious illness during which a person suffers from the dangerous combination of depressed mood and psychosis; with the psychosis commonly manifesting itself as nihilistic-type delusions, or that bad things are about to happen. While psychotic depression is treatable if recognized, the diagnosis is frequently missed, which can lead to the prescription of ineffective treatments and unfortunate outcomes. Recent data from the National Institute of Mental Health (NIMH) Study of the Pharmacotherapy of Psychotic Depression (STOP-PD) suggest that the diagnosis is indeed often missed in both the emergency room and inpatient hospital settings (1). A further complication when treating psychotic depression is that no medications are approved by the Food and Drug Administration (FDA) for the treatment of this specific disorder, leaving the clinicians to base their decisions regarding patient treatment on only a very few studies published in the medical literature.
