Psychotic depression was initially considered to be at one end of a continuum of severity of major depression. Subsequent experience demonstrated that psychosis is an independent trait that may accompany mood disorders of varying severity. While much has been learned about the impact of severe mood congruent delusions and hallucinations on the course and treatment response of depression, less is known about fleeting or mild psychosis, mood incongruent features, or psychotic symptoms that reflect traumatic experiences. Acute treatment of psychotic unipolar depression generally involves the combination of an antidepressant and an antipsychotic drug or electroconvulsive therapy. There is inadequate information about maintenance treatment of unipolar psychotic depression and acute and chronic treatment of psychotic bipolar disorder. Decision-making therefore still must rely in part on clinical experience.
Psychother Psychosom

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精神病性抑郁症：诊断、鉴别诊断和治疗

精神病性抑郁症最初被认为是重性抑郁症严重程度连续体的一端。随后的经验表明，精神病是一种独立的特征，可能伴随不同严重程度的情绪障碍。虽然关于严重情绪一致性妄想和幻觉对抑郁症病程和治疗反应的影响已经了解很多，但对短暂或轻度精神病、情绪不一致特征或反映创伤经历的精神病症状知之甚少。精神病性单相抑郁的急性治疗通常涉及抗抑郁药和抗精神病药物或电休克疗法的组合。关于单相精神病性抑郁症的维持治疗和精神病性双相障碍的急性和慢性治疗的信息不足。
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