Materiały źródłowe

• #1 Major depression with psychotic features: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000933.htm

  Major depression with psychotic features is a mental disorder in which a person has depression along with loss of touch with reality (psychosis). […] People with psychotic depression have symptoms of depression and psychosis. […] Psychotic depression requires immediate medical care and treatment. […] This is a serious condition. You will need immediate treatment and close monitoring by a provider. […] The risk for suicide is much higher in people with depression with psychotic symptoms than in those without psychosis.

• #2 Psychotic depression – NHS

  https://www.nhs.uk/mental-health/conditions/psychotic-depression/

  Some people who have severe depression may also experience hallucinations and delusional thinking, the symptoms of psychosis. […] Depression with psychosis is known as psychotic depression. […] People with psychotic depression have an increased risk of thinking about suicide. […] Treatment for psychotic depression involves: medicine a combination of antipsychotics and antidepressants can help relieve the symptoms of psychosis […] talking therapies the 1-to-1 talking therapy cognitive behavioural therapy (CBT) has proved effective in helping some people with severe depression, including those with psychosis […] The person may need to stay in hospital for a short period of time while they’re receiving treatment. […] Electroconvulsive therapy (ECT) may sometimes be recommended if the person has severe depression and other treatments, including antidepressants, have not worked. […] Treatment is usually effective, but follow-up appointments so that the person can be closely monitored are usually required.

• #3 Psychotic Depression: What Is It, Symptoms, Causes, and MoreHealthline

  https://www.healthline.com/health/depression/psychotic-depression

  Major depressive disorder with psychosis may cause symptoms including hallucinations or delusions during a depressive episode. Treatment may include medication and other forms of therapy. […] Psychotic depression refers to major depressive disorder (MDD) with features of psychosis, a specific presentation of depression. It involves symptoms of psychosis during an episode of depression. […] Estimates based on community samples suggest MDD with psychosis affects anywhere from 10 to 19 percent of people having an episode of major depression. Among people receiving inpatient care for depression, this rate increases to: […] Depression is always serious. Still, experts tend to consider MDD with psychosis more serious than depression without psychosis because it’s more likely to involve: […] If you experience both depression and psychosis, you’ll want to get support from a mental health professional right away. This condition typically doesn’t improve without professional treatment.

• #4 Psychotic Depression: Underrecognized, Undertreated-and Dangerous

  https://www.psychiatrictimes.com/view/psychotic-depression-underrecognized-undertreatedand-dangerous

  Psychotic Depression: Underrecognized, Undertreated-and Dangerous […] This article describes the history of this diagnostic construct for the Study of the Pharmacotherapy of Psychotic Depression (STOP-PD) and summarizes research on the epidemiology, significance, diagnostic complexity, and treatment of psychotic depression. Case vignettes are provided to highlight diagnostic and therapeutic issues. […] The overall community prevalence of PMD is 0.4%; it occurs in 14% to 20% of individuals with MDD. The prevalence of PMD is markedly higher among hospitalized patients; it exceeds 25% in mixed-age adults and occurs in up to 45% of depressed geriatric inpatients. […] PMD is associated with severe health consequences. Relapse and recurrence rates approximating 50% have been reported. Compared with patients who have MDD, patients with PMD have poorer outcomes; they have more residual symptoms, greater functional impairment, and more frequent suicide attempts as well as more malignant health outcomes.

• #5 Major depression with psychotic features Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/major-depression-with-psychotic-features

  Psychotic depression requires immediate medical care and treatment. […] Treatment usually involves antidepressant and antipsychotic medicine. You may only need antipsychotic medicine for a short period of time. […] This is a serious condition. You will need immediate treatment and close monitoring by a provider. […] The risk for suicide is much higher in people with depression with psychotic symptoms than in those without psychosis. You may need to stay in the hospital if you have thoughts of suicide. […] Contact your provider right away if you hear voices that are not there. […] If you or someone you know is thinking about suicide, call or text 988 or chat 988lifeline.org.

• #6 Psychotic Depression | Behavioral and Mental Health | Mercy Health

  https://www.mercy.com/health-care-services/behavioral-mental-health/conditions/psychotic-depression

  Psychotic depression is a very serious mood disorder. People with this condition have extreme feelings of worthlessness and hopelessness. They might also have visions of unreality. This means they can hear voices or have beliefs that aren’t really there or true. One out of every four people who goes to the hospital with depression has a form of psychotic depression. […] It can be very difficult to diagnose someone with psychotic depression. This condition isn’t well-studied. Often, people hide their symptoms as part of their depression. But, it’s essential that you talk with a trained mental health professional immediately if you have any symptoms of psychotic depression. This is because the rate of suicide or suicidal threats can be very high with this condition. […] There’s currently no cure for psychotic depression. There are treatments that can help relieve your symptoms. Your mental health professional can work with you and your loved ones to create a treatment plan. This may help you feel better and connect better with the world around you. Nonsurgical treatments for psychotic depression include the following: Medications are often a big part of treatment for psychotic depression. You might combine antidepressants and antipsychotic medicines so they work better. It can take some adjustment to find the right level of medicine for you. […] Early diagnosis is important for successful treatment of psychotic depression. It may be a scary diagnosis, but you can easily get help. Be sure that loved ones are aware of the situation and your treatment program so they can support you during this time.

• #7 Major depression with psychotic features | Lima Memorial Health System

  https://www.limamemorial.org/health-library/hie%20multimedia-textonly/1/000933

  Major depression with psychotic features is a mental disorder in which a person has depression along with loss of touch with reality (psychosis). […] People with psychotic depression have symptoms of depression and psychosis. […] Psychotic depression requires immediate medical care and treatment. […] Treatment usually involves antidepressant and antipsychotic medicine. […] This is a serious condition. You will need immediate treatment and close monitoring by a provider. […] The risk for suicide is much higher in people with depression with psychotic symptoms than in those without psychosis.

• #8 Psychotic Depression: Symptoms, Causes, Diagnosis, and Treatment

  https://www.verywellmind.com/psychotic-depression-1066607

  Psychotic depression involves having symptoms of severe depression along with psychosis. This condition involves the usual symptoms of depression, such as depressed mood, appetite changes, and loss of interest in activities previously enjoyed. […] A person with psychotic depression will experience a combination of depression symptoms, potentially including: depressed mood, diminished interest or pleasure in activities previously enjoyed, fatigue or lack of energy, feelings of worthlessness or guilt, inability to concentrate, significant changes in weight and appetite, sleep difficulties, and thoughts of death or suicide. […] In addition to the above symptoms, people with psychotic depression will also experience delusions and/or hallucinations. […] There is currently no federally approved treatment for psychotic depression. However, the American Psychiatric Association (APA) recommends either the combination of an antidepressant and antipsychotic or electroconvulsive therapy (ECT) as the first-line treatment for psychotic depression.

• #9 Psychotic Depression: A Scientific Guide

  https://www.everydayhealth.com/depression/psychotic-depression-losing-touch-with-reality.aspx

  People with psychotic depression are prone to hallucinations (seeing or hearing things that aren’t there) and delusions (strong beliefs that are not rooted in reality). […] Psychotic depression is a condition in which a person with depression is also experiencing a detachment from reality, known as psychosis. […] The disorder is sometimes also referred to as major depression with psychotic features, according to MedlinePlus. […] Psychotic depression is very serious, and it requires immediate and prompt treatment. […] The risk of suicide is significantly higher in individuals with psychotic depression than in those with depression alone, according to the Icahn School of Medicine at Mount Sinai in New York City. […] Importantly, women who develop psychotic depression after pregnancy are at special risk for horrific consequences, particularly homicide and infanticide, if their psychotic symptoms are not treated, Meyers says.

• #10 Psychotic depression – HSE.ie

  https://www2.hse.ie/conditions/clinical-depression/psychotic-depression/

  If you have severe clinical depression you may also experience hallucinations and delusional thinking. These are the symptoms of psychosis. […] Depression with psychosis is called psychotic depression. […] If you have psychotic depression, you may also have psychomotor retardation. This is when your thoughts and physical movements slow down. […] People with psychotic depression have an increased risk of thinking about suicide. […] Treatment for psychotic depression involves: medicine – antipsychotics and antidepressants, psychological therapies – cognitive behavioural therapy (CBT), social support – support with social needs, such as education, employment or accommodation. […] You may need to stay in hospital for a short time while you are getting treatment. […] Electroconvulsive therapy (ECT) is sometimes used if all other treatments have not worked.

• #11

  https://www.rula.com/blog/depression-psychosis/

  People with depressive psychosis often experience hallucinations and delusions that are consistent with their depressed mood. […] The recommended treatment for depression with and without psychotic features can be different. […] Some of the most effective treatments for psychotic depression include: Therapy methods like cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) can help you learn how to deal with triggers, keep your stress levels low, and adopt healthy coping skills. […] Medication can help manage symptoms of both depression and psychosis, although there are no medications approved for this specific combination. […] It’s important to work with a qualified mental healthcare provider to determine a treatment plan that is aligned with your specific needs and goals. […] A therapist can help you get access to the diagnosis and treatment that can help you overcome these symptoms and start to feel safe and happy again.

• #12 F33.3 – ICD-10 code for major depressive disorder, recurrent, severe with psychotic features

  https://www.upheal.io/icd-10-codes/recurrent-psychotic-depression

  For accurate diagnosis and coding, clinicians must identify both severe depressive symptoms and the presence of psychotic features (hallucinations and/or delusions). […] Like the difference between an ordinary mirror and a funhouse mirror, psychotic depression creates profound distortions in how reality is perceived. […] The presence of psychotic symptoms creates a distinct clinical profile that requires careful assessment. […] Hallucinations and delusions in psychotic depression often align with depressive themes like guilt, worthlessness, or persecution. […] Common psychotic features include: Hallucinations (particularly auditory), Delusions of guilt or worthlessness, Nihilistic delusions, Somatic delusions, Persecutory delusions. […] Hallucinations (80%) are more common than delusions (32%) in outpatient settings, though both can occur simultaneously.

• #12 F33.3 – ICD-10 code for major depressive disorder, recurrent, severe with psychotic features

  https://www.upheal.io/icd-10-codes/recurrent-psychotic-depression

  Living with severe recurrent depression with psychotic features can feel like being trapped in a funhouse with distorted mirrors and shifting floors except there’s nothing fun about it. […] For those experiencing severe recurring episodes of depression with psychotic features, this profoundly disorienting journey repeats itself, creating deep disruptions in their understanding of reality and daily functioning. […] Psychotic depression is frequently underdiagnosed in clinical settings, with the diagnosis being missed in 27% of cases. […] This high rate of missed diagnosis is particularly concerning given that patients with psychotic depression have over twice the mortality rate compared to those with non-psychotic depression, even after controlling for age and medical illness. […] Using the F33.3 code requires careful clinical assessment of both symptom patterns and functional impact.

• #12 F33.3 – ICD-10 code for major depressive disorder, recurrent, severe with psychotic features

  https://www.upheal.io/icd-10-codes/recurrent-psychotic-depression

  Unlike milder forms of depression that may respond to psychotherapy alone, psychotic depression often calls for intensive, multi-modal treatment. […] Evidence strongly supports combining antidepressant and antipsychotic medications as first-line treatment. […] Just as someone trapped in a funhouse needs a steady guide to find their way out, clients with psychotic depression require comprehensive support and careful treatment planning. […] While the combination of severe depression and psychotic features can feel overwhelming, evidence-based treatments offer real hope for recovery. […] Proper clinical documentation plays a crucial role in tracking both depressive and psychotic symptoms while ensuring appropriate care coordination.

• #13 Psychotic Depression: Underrecognized, Undertreated-and Dangerous

  https://www.psychiatrictimes.com/view/psychotic-depression-underrecognized-undertreatedand-dangerous

  An index episode of PMD predicts a greater than 2-fold higher 15-year mortality rate and 3-fold greater risk of suicide after an initial suicide attempt. The longitudinal risk for suicide is substantial because approximately 20% of patients with PMD make a suicide attempt during an episode. The association between suicidal outcomes and PMD presumably results from the behavioral impact of PMD: conviction about highly pessimistic and/or paranoid beliefs that occur in association with the pain of depression may make the choice of suicide appear as rational. Therefore, depressed patients must be assessed for both suicidal and delusional ideas, and depressive and psychotic domains of illness must be treated. […] Diagnosis […] PMD is often considered interchangeable with delusional depression because the vast majority of patients with psychosis have delusional ideation, whereas hallucinations without delusions are less common. Delusions are fixed beliefs that are resistant to the laws of logic and evidence to the contrary. Psychiatrists expect their depressed patients to have pessimistic and fearful concerns; unfortunately, extra diagnostic rigor is required to differentiate depressive ruminations from the fixed beliefs of PMD.

• #14 Psychotic Depression: What Is It, Symptoms, Causes, and MoreHealthline

  https://www.healthline.com/health/depression/psychotic-depression

  Treatment for psychotic depression generally involves psychotropic medications, though you have other options, too. […] Typically, medication treatment involves a combination of antidepressants and antipsychotics. These medications help balance neurotransmitters in the brain. […] Your care team may also recommend ECT for severe depression that doesn’t respond to medication or therapy. […] While therapy alone may not do much to improve symptoms of psychosis on its own, it can still have benefit as a supportive approach. […] MDD with psychosis can sometimes resemble schizophrenia, another mental health condition that involves psychosis. The main difference lies in when psychosis shows up: […] MDD with psychosis is a serious mental health condition that requires prompt treatment from a trained mental health professional. You do have options for treatment, and the right approach can improve symptoms of both depression and psychosis.

• #15 Depression With Psychotic Features | Charlie Health

  https://www.charliehealth.com/post/depression-with-psychotic-features

  Major depression with psychotic features is a severe form of depression that includes symptoms of psychosis, as well as an increased risk of suicide and self-harm. Learn how to get help today. […] Depression with psychotic features is a severe form of major depressive disorder (MDD) that includes psychotic symptoms, such as delusions, hallucinations, and psychomotor impairment. […] MDD with psychotic features can lead to complications such as problems at work or school, withdrawal from usual activities, self-harm, and even suicide. […] If you’re experiencing suicidal thoughts or are in danger of harming yourself, this is a mental health emergency. […] When it’s established that someone has depression with psychosis, it’s essential to connect them with appropriate and timely care. […] Timely access to care is also necessary for the safety of the person experiencing MDD with psychosis and safety of others exposed to the person experiencing the psychotic depression symptoms and diagnosis.

• #16 Major Depressive Disorder (MDD) – PsychDB

  https://www.psychdb.com/mood/1-depression/home

  Psychotic Depression (also known as Major Depressive Disorder with psychotic features in the DSM-5) is a subtype of depression characterized by psychosis (delusions, hallucinations) in addition to mood changes. It requires the treatment of the underlying mood disorder first to resolve the psychosis. […] With psychotic features, delusions and/or hallucinations are present. […] With mood-congruent psychotic features: The content of all delusions and hallucinations is consistent with the typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment. […] With mood-incongruent psychotic features: The content of the delusions or hallucinations does not involve typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment, or the content is a mixture of mood-incongruent and mood-congruent themes.

• #17 FloridaHealthFinder | Major depression with psychotic features | Health Encyclopedia | FloridaHealthFinder

  https://quality.healthfinder.fl.gov/health-encyclopedia/HIE/1/000933

  Major depression with psychotic features is a mental disorder in which a person has depression along with loss of touch with reality (psychosis). […] Psychotic depression requires immediate medical care and treatment. […] Treatment usually involves antidepressant and antipsychotic medicine. […] Electroconvulsive therapy can help treat depression with psychotic symptoms. However, medicine is usually tried first. […] This is a serious condition. You will need immediate treatment and close monitoring by a provider. […] The risk for suicide is much higher in people with depression with psychotic symptoms than in those without psychosis. […] Contact your provider right away if you hear voices that are not there. […] You may need to stay in the hospital if you have thoughts of suicide.

• #18 Psychotic Depression – Bridges to Recovery

  https://www.bridgestorecovery.com/psychotic-depression/

  A period of hospitalization may be required when psychotic depression develops, since untreated psychosis can lead to self-destructive actions or reckless behavior that puts other people at risk. […] People with psychosis may require emergency hospitalization before entering an inpatient or outpatient treatment program. During their hospitalization they may be administered antipsychotic medications such as Zyprexa, Seroquel, or Risperdal, which can stabilize their conditions by halting the progression of their hallucinations and delusions. […] In formal inpatient or outpatient treatment programs for psychotic depression, psychotherapy in individual, group, and family formats will be combined with appropriate medications, which generally includes a mixture of antipsychotics and antidepressants. Treatment and rehabilitation may be further advanced through the addition of holistic healing practices, life skills classes, educational offerings, and any individualized services recommended by members of a patient’s treatment team.

• #19 Psychotic Depression: Underrecognized, Undertreated-and Dangerous

  https://www.psychiatrictimes.com/view/psychotic-depression-underrecognized-undertreatedand-dangerous

  Acute and postremission treatment of PMD […] Consensus guidelines consider 2 treatments as effective for PMD: ECT and pharmacotherapy that combines an antidepressant with an antipsychotic. Results from a STOP-PD randomized controlled trial (RCT) demonstrated the efficacy of combined olanzapine (average dosage, 14.7 mg/d) and sertraline (average dosage, 170 mg/d) compared with olanzapine plus placebo. The 12-week remission rate of 41.2% was comparable to remission rates reported in RCTs of less depressed outpatients. […] Future directions […] Knowledge about the diagnosis and treatment of PMD has increased markedly over the past 35 years. Nevertheless, advances in the understanding of underlying pathophysiology of one of the few spontaneously occurring and fully reversible psychotic conditions have emerged slowly. The cortisol dysregulation hypothesis continues to gain support, with an increasing focus on genes that regulate central glucocorticoid receptors. From the perspective of phenomenology, conceptualization of psychosis and delusional thinking as domains of interest would facilitate research into irrational thinking within and across psychiatric disorders.

• #20 Major Depression: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/major-depression-nursing-diagnosis-care-plan/

  Educate on medication adherence. Antidepressants require a few weeks or more to take effect. Abrupt medication cessation can cause withdrawal and worsening of depression. […] Monitor for an increased risk of suicide. Children, adolescents, and young adults are at an increased risk for suicide when starting an antidepressant. […] Initiate psychotherapy. Refer the patient to a mental health professional for psychotherapy, also known as talk therapy. Cognitive behavioral therapy and interpersonal therapy are two types of psychotherapy that are effective in treating MDD. […] Ensure support and offer resources. Its important that the patient doesnt feel isolated. Identify friends, family, religious groups, and support groups the patient can rely on when needed. […] Risk for Self-Mutilation: Patients with major depression participate in self-mutilating behaviors to feel more in control over stressful situations and to cope with emotional pain. […] Risk for Suicide: Patients with major depression that is not controlled may experience greater feelings of hopelessness which is associated with suicidal thoughts. […] Self-Care Deficit: Major depression can affect the patients motivation and energy in completing self-care tasks.

• #20 Major Depression: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/major-depression-nursing-diagnosis-care-plan/

  Nurses may encounter patients experiencing MDD or other mental health conditions as a comorbidity exacerbated by a medical condition such as chronic pain, cancer, or a terminal illness. Major depression requires the diagnosis and treatment of trained mental health providers, but nurses are vital in creating a therapeutic relationship that allows patients to express their thoughts and feelings while supporting them holistically and maintaining their safety. […] Nursing interventions and care are essential for the patients recovery. In the following section, you will learn more about possible nursing interventions related to depression. […] Administer medications as ordered. Depression may occur due to abnormalities in neurotransmitters (serotonin, norepinephrine, dopamine), which is why antidepressants are effective in treating these imbalances.

• #21 Psychotic Depression: Facts, Causes, Diagnosis, Treatments

  https://www.verywellhealth.com/psychotic-depression-5193047

  Treatment for psychotic depression typically involves medication and/or electroconvulsive therapy (ECT), electrical stimulation of the brain. […] While unlikely to be effective treatments for psychotic depression on their own, some lifestyle changes can help with symptom management, treatment support, and quality of life. […] Psychotherapy (talk therapy) on its own has not been shown to be effective at treating psychotic depression. It is sometimes used in combination with other types of therapies and medications. […] ECT is considered a safe and effective treatment for psychotic depression. It may be more effective than medication, and it is recommended as a first-line treatment in many guidelines because of its quick results. […] A combination of an antipsychotic and an antidepressant medication is usually more effective for treating psychotic depression than treatment with either medication alone.

• #22 Psychotic Depression: A Scientific Guide

  https://www.everydayhealth.com/depression/psychotic-depression-losing-touch-with-reality.aspx

  When it comes to medication treatment for psychotic depression, studies have shown that combining an antidepressant with an antipsychotic is the best approach. […] Doctors will often try to wean patients off the antipsychotic medicine because they can cause unwanted side effects, such as weight gain, high cholesterol, and metabolic syndrome. […] ECT is a treatment that involves delivering small electrical currents through the brain to trigger a brief seizure, which is thought to cause changes in an individual’s brain chemistry that help symptoms of depression. […] With proper treatment, many people can find complete relief from the symptoms of psychotic depression, says Rothschild. […] Untreated psychotic depression can lead to dangerous complications. […] The delusions a person experiences increase the likelihood that they will perform acts of violence, suicide, and even homicide, according to Meyers. […] If you think that you or a loved one is experiencing psychotic depression, it’s important to get help right away. […] A good support system is also critical for someone with psychotic depression.

• #23 Psychotic depression | mentalhealthcare.org.uk

  https://www.mentalhealthcare.org.uk/mental-health-diagnoses/psychotic-depression/

  When some people have a major depressive disorder or severe clinical depression as it is most commonly called, they can experience delusions and hallucinations. These people are described as having psychotic depression. […] People will be referred to specialist mental health professionals if they have delusions and hallucinations alongside severe clinical depression. It is also a requirement for some of these people to spend time in hospital. […] Initially, treatment focuses on the depression and not the psychosis symptoms. Normally, people will already have medication for their severe depression e.g. antidepressants or a drug combination that might include mood stabilisers, antidepressants and anxiolytics (drugs for anxiety). […] When hallucinations and delusions develop, specialist mental health workers might also prescribe antipsychotic medication. […] Psychotic depression sufferers may also benefit from electroconvulsive therapy (ECT). […] Other treatments on offer for severe clinical depression are in the development and testing process.

• #24 What is psychotic depression? Symptoms, causes, and treatment – Grow Therapy

  https://growtherapy.com/blog/what-is-psychotic-depression/

  Therapy for psychotic depression can include coping strategies such as mindfulness and relaxation exercises when symptoms occur. […] Therapists can help clients diagnosed with psychotic depression with communication skills to help enhance their relationships. […] A therapist can provide support to the family of the person diagnosed with psychotic depression by providing psychoeducation on the condition and information on family support groups. […] Effective treatment includes a multifaceted approach that provides talk therapy, medications, and access to inpatient facilities.

• #24 What is psychotic depression? Symptoms, causes, and treatment – Grow Therapy

  https://growtherapy.com/blog/what-is-psychotic-depression/

  Psychotic depression requires a different treatment approach where both the depressive and psychotic symptoms are addressed. […] Psychotic depression medications help balance neurotransmitters in the brain. […] Therapy plays a crucial role in managing psychotic depression by addressing both the depressive and psychotic symptoms through various therapeutic approaches. […] Psychotherapy for psychotic depression can include cognitive behavioral therapy. […] Electroconvulsive Therapy (ECT) may be recommended for severe depression that hasn’t responded to medication or therapy. […] A medical provider may recommend a stay at a psychiatric hospital to treat psychosis if it is severe or if an individual is displaying erratic behavior or experiencing persistent thoughts of harming themselves or others.

• #25 Psychotic Depression – BrightQuest Treatment Centers

  https://www.brightquest.com/mood-disorders/residential-treatment-for-psychotic-depression/

  People with severe depression may experience psychosis, a serious complication that usually requires emergency intervention. […] Fortunately, major depression with psychotic features can be overcome if comprehensive treatment services are provided. Residential treatment for psychotic depression at BrightQuest is evidence-based and highly effective, especially for clients who have the support of their families and are dedicated to the recovery process. […] People with psychotic depression need extensive medical assistance, which will include treatment for their major depressive disorder along with its psychotic aspects. Residential treatment for psychotic depression at BrightQuest is administered by world-class mental health experts, who design individualized wellness plans featuring a full menu of appropriate recovery services.

• #26 Major Depression Nursing Care Management

  https://nurseslabs.com/major-depression/

  Nursing Management: These are the nursing responsibilities for taking care of patients with major depression. […] Nursing Assessment: Subjective cues include verbalization of inability to cope or ask for help, sleep disturbance and fatigue, abuse of chemical agents, and reports of muscular or emotional tensions, and lack of appetite. […] Objective cues include lack of goal-directed behavior or resolution of problem; inadequate problem solving, decreased use of social support, inability to meet role expectations/basic needs, and destructive behavior toward self (e.g. overeating, smoking/drinking, overuse of prescribed/OTC medications, and illicit drug use). […] Nursing Diagnosis: Ineffective Coping related to situational or maturational crises. […] Hopelessness related to long-term stress.

• #27 Depression & Suicide: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/depression-and-suicide/?srsltid=AfmBOoqWCVq_32dZBrJ5UhNIvTs8LQnhI5kdNJUN4xTDbLKBbZ1k5ohy

  Psychotic depression is one of the types of depression. […] Administer proper care to keep individual from harm. […] Administer prescribed medications, such as antidepressants. […] Refer for counseling and follow-up psychiatric care. Treatments may include: Cognitive behavioral therapy, Psychotherapy, Psychodynamic therapy, Brain stimulation therapies, Electroconvulsive therapy may be utilized in some cases, Repetitive transcranial magnetic stimulation (rTMS). […] Expected outcomes include being responsive to medical treatment for depression and having no suicidal ideation.

• #28 Major Depression Nursing Care Management

  https://nurseslabs.com/major-depression/

  Fatigue related to stress and anxiety. […] Planning and Goals: To determine degree of impairment. […] To assess coping abilities and skills. […] To assist client to deal with current situation. […] To provide for meeting psychological needs. […] To promote wellness. […] Nursing Interventions: Provide for patients physical needs. […] Assist with self-care and personal hygiene. […] Encourage the patient to eat. […] Give warm milk or back rubs at bedtime to improve sleep. […] Plan activities for times when the patients energy level peaks. […] Assume active role in initiating communication. […] Educate patient about depression. […] Ask patient whether he thinks about death or suicide. […] Stress the need for medication compliance. […] Discharge and Home Care Guidelines: Long-term needs and actions to be taken.

• #29 Major Depression Nursing Care Management

  https://nurseslabs.com/major-depression/

  Support system available, specific referrals made, and who is responsible for actions to be taken. […] Documentation Guidelines: Record all observations and conversations with the patient because these are valuable in evaluating his response to treatment. […] Pediatric Considerations: Here are nursing care tips for children with major depression: Structure and maintain a safe environment. […] Monitor closely for dangerous or self-destructive behaviors. […] Develop an agreement or contract with child about seeking a staff whenever he feels desperate or suicidal. […] Teach child to talk things out rather than act things out. […] Help child talk about problems and stressors. […] Provide physical outlets for energy and aggression release (e.g. sports, music, art, etc.). […] Help identify supportive people and help child learn ways to talk to these people about his feelings and needs.

• #30 Managing Psychotic Depression Symptoms in Children

  https://www.mindweal.com/depression-conditions/

  Empower Your Child with Self-Guided care for depression, enabling them to take control of their well-being. […] Provide parents with detailed information about depressive disorders, including symptoms, triggers, and impact on their child’s daily life, fostering recognition and empathy for their child’s experiences. […] Assist parents in creating a nurturing and safe environment at home that encourages open communication, validation of emotions, and provides a sense of stability. […] Guide parents on teaching their child effective coping skills to manage depression, including deep breathing, mindfulness, positive self-talk, and problem-solving.

• #31 Psychotic Depression – BrightQuest Treatment Centers

  https://www.brightquest.com/mood-disorders/residential-treatment-for-psychotic-depression/

  Healing from serious mental health challenges requires the support and loving care of family members, who are encouraged to participate in BrightQuest treatment plans as active members of their loved ones’ recovery teams. […] The BrightQuest approach to recovery from psychotic depression is compassionate and inclusive. Working together, we’ll co-create a healing team of experts and compassionate supporters who will motivate and inspire your loved one to strive for wellness. […] At BrightQuest, residential treatment for psychotic depression can have a profound impact on your loved one’s life. Under our careful guidance, they will learn to manage their symptoms of depression and regain their health and autonomy.

• #32 What Causes Psychotic Depression, and How Is It Treated? – BrightQuest Treatment Centers

  https://www.brightquest.com/blog/what-causes-psychotic-depression-and-how-is-it-treated/

  We can explore the causes and risk factors for psychotic depression and then turn our attention to the solutions. The treatment options for major depressive disorder with psychotic features are comprehensive and successful, especially when established in a long-term in-patient treatment setting. […] Because of unsettling experiences not grounded in reality on top of the devastating experience of depression, sufferers of psychotic depression may be at great risk of self-neglect or of harming themselves or others. Regardless of what causes psychotic depression, the onset of psychotic symptoms presents a psychiatric emergency, and these individuals need urgent medical and psychological care. […] If someone with psychotic depression starts treatment early and stays on the treatment path in close cooperation with their medical and psychological teams, they have a good long-term chance of leading a positive life in recovery. Major depression, in general, and major depression with psychotic features, in particular, are mental health disorders that require early and persistent expert care.

• #33 Pathways of care and attitudes toward psychotropics in patients with depressive disorders and psychotic disorders – Journal of Neurosciences in Rural Practice

  https://ruralneuropractice.com/pathways-of-care-and-attitudes-toward-psychotropics-in-patients-with-depressive-disorders-and-psychotic-disorders/

  The psychiatrist remained the most common first treatment contact (46% in depression and 62% in psychosis). […] Patients in depressive group had more favorable attitude toward psychotropics compared to psychosis group. […] Majority of patients had favorable attitude toward psychotropic medications, but they also had substantial misconceptions about side effects, utility, and need of taking lesser than prescribed doses. […] Although majority of patients had favorable attitude, they also had substantial misconceptions about medications. These issues need to be addressed for better delivery of comprehensive mental healthcare. […] Proper understanding of mental health care-seeking behavior and the factors influencing the attitude toward the psychotropics is essential for the better access to the appropriate health-care system and ensuring the compliance toward treatment.

• #33 Pathways of care and attitudes toward psychotropics in patients with depressive disorders and psychotic disorders – Journal of Neurosciences in Rural Practice

  https://ruralneuropractice.com/pathways-of-care-and-attitudes-toward-psychotropics-in-patients-with-depressive-disorders-and-psychotic-disorders/

  In both the groups, larger proportion of patients reported beneficial effects with psychotropic medications such as preventing breakdown (relapse/exacerbation), feeling relaxed, and more normal with clear thinking with medications. However, substantial proportion of patients in both the groups had certain unfavorable attitude toward psychotropics such as feeling of controlled with medications, feeling doped, tired, or sluggish with medications, and taking medications only on feeling ill. […] Although majority of patients had favorable attitude about efficacy of psychotropics, they also had substantial misconceptions about side effects, utility, and need of taking lesser than prescribed doses.

• #34 Psychotic Depression – Bridges to Recovery

  https://www.bridgestorecovery.com/psychotic-depression/

  Because of the disabling nature of the disorder, long-term treatment for psychotic depression is usually necessary. That may include an extended stay in residential inpatient treatment programs (90 days or longer), plus participation in aftercare regimens that continue for several months following the cessation of formal treatment. […] Despite the frightening nature of this disorder, the long-term prognosis for psychotic depression is highly promising for patients who remain committed to their depression recovery programs. Psychotic depression is responsive to comprehensive treatment, and in the long run its most severe symptoms can be effectively managed or eliminated.

• #35 Psychotic Depression: A Scientific Guide

  https://www.everydayhealth.com/depression/psychotic-depression-losing-touch-with-reality.aspx

  But when patients do seek medical support, psychotic depression is treatable, and many people achieve full remission, says Anthony J. Rothschild, MD. […] The symptoms of psychotic depression include classic signs of depression combined with features of psychosis, say Meyers and Rothschild. […] Psychotic symptoms are associated with a doubled risk of suicide among people with severe depression, who already have an elevated suicide risk because of their depression. […] The delusions are usually of a depressing kind, such as bad things are going to happen type of delusions, adds Rothschild. […] Currently, no treatment is approved by the U.S. Food and Drug Administration (FDA) specifically to treat psychotic depression, says Rothschild. […] The APA recommends either the combination of an antidepressant and an antipsychotic or electroconvulsive therapy (ECT) to treat the illness, on the basis of various studies that show effectiveness.

• #36 Depression | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/mental-health/depression/

  Electroconvulsive therapy (ECT, or electric shock treatment) is sometimes recommended if other treatments, including antidepressants, haven’t worked for severe depression. […] Although treatment for psychotic depression is usually very effective, people with the condition still need follow-up appointments with their treatment team so they can be continuously monitored.

• #37

  https://scholars.duke.edu/display/pub761788

  OBJECTIVE: People with serious mental illness have higher mortality rates than the general population, and this difference is not explained by such causes as suicide or accidents. This study therefore examined access and barriers to medical care among persons with serious mental illness. […] Persons with psychotic disorders (odds ratio [OR]=.55, 95% confidence interval [CI]=.44-.69) and bipolar disorder (OR=.74, CI=.56-.98) had significantly reduced odds of having a primary care physician compared with people without mental disorders. For any barriers to care, persons with psychotic disorders, bipolar disorder, or major depressive disorder had greatly increased odds (ORs=2.5-7.0) of reporting difficulties in accessing care. […] Persons with psychotic disorders and bipolar disorder reported markedly more difficulty in obtaining a primary care physician and greater barriers to care than the general population. Interventions are needed to improve provision of primary medical care to this population.

• #38 Psychotic Depression: Underrecognized, Undertreated-and Dangerous

  https://www.psychiatrictimes.com/view/psychotic-depression-underrecognized-undertreatedand-dangerous

  In STOP-PD, 27% of patients who had delusions did not receive a diagnosis of PMD. Because depressive ruminations that focus on themes of somatic, financial, and guilty concerns are expected concomitants of MDD, clinicians may ignore the question of whether these concerns are held fixedly and are influencing the patient’s behavior. Paranoid concerns are more likely to focus attention on the possible presence of delusions, particularly if the fears are not congruent with a depressive theme. […] In light of diagnostic inaccuracy, it is not surprising that nearly 20% of research participants who met criteria for PMD had not received antidepressants before study entry, 25% had not received an antipsychotic medication, and only 10% had received intensive pharmacotherapy with both an antipsychotic and an antidepressant.

• #39 Diagnostic Considerations in Major Depressive Disorder With Psychotic Features – Psychiatry Advisor

  https://www.psychiatryadvisor.com/news/diagnostic-considerations-in-major-depressive-disorder-with-psychotic-features/

  Patients with MDD with psychotic features also had a more than 2.2-fold higher likelihood for treatment resistance than those without (79.87% vs 35.75%). […] Only 3.25% of the patients with psychotic MDD achieved treatment response, compared with 27.15% of patients who had non-psychotic MDD. […] Further research projects could identify biomarkers or use neuroimaging techniques to differentiate patients with psychotic MDD from patients without psychotic symptoms earlier in the course of the disease, the investigators concluded. Subsequently, patients could receive appropriate treatment in the early phase of their depressive episode.

• #40 Pharmacological treatment for psychotic depression | Cochrane

  https://www.cochrane.org/CD004044/DEPRESSN_pharmacological-treatment-psychotic-depression

  Psychotic depression is a severe depression with psychotic features (i.e. delusions and/or hallucinations). […] The aim of this review is to compare the efficacy of the various forms of drug treatment that have been used to treat psychotic depression. […] From these trials, we found evidence that the combination of an antidepressant plus an antipsychotic provides more effective treatment for psychotic depression than either treatment alone. […] Some evidence indicates that combination therapy with an antidepressant plus an antipsychotic is more effective than either treatment alone or placebo. […] Evidence is limited regarding the most effective pharmacological treatment for psychotic depression: monotherapy with an antidepressant, monotherapy with an antipsychotic, another treatment (e.g. mifepristone), or combination of an antidepressant plus an antipsychotic.

• #41 Sustaining remission of psychotic depression: rationale, design and methodology of STOP-PD ΙΙ | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-13-38

  Given the absence of data informing the continuation or discontinuation of antipsychotic medication in remitted PD, STOP-PD II provides the unique opportunity to study the effect of antipsychotic discontinuation (as opposed to switching antipsychotics) on antipsychotic-related weight gain and metabolic effects. […] STOP-PD II addresses an issue of profound clinical importance in the management of PD: what are the risks and benefits of continuing antipsychotic medication in remitted PD. The findings of this study will provide clinicians with a much-needed evidence base to guide the continuation treatment of one of the most disabling and lethal psychiatric disorders.

• #42 Sustaining remission of psychotic depression: rationale, design and methodology of STOP-PD ΙΙ | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-13-38

  Psychotic depression (PD) is a severe disabling disorder with considerable morbidity and mortality. Electroconvulsive therapy and pharmacotherapy are each efficacious in the treatment of PD. Expert guidelines recommend the combination of antidepressant and antipsychotic medications in the acute pharmacologic treatment of PD. However, little is known about the continuation treatment of PD. Of particular concern, it is not known whether antipsychotic medication needs to be continued once an episode of PD responds to pharmacotherapy. This issue has profound clinical importance. On the one hand, the unnecessary continuation of antipsychotic medication exposes a patient to adverse effects, such as weight gain and metabolic disturbance. On the other hand, premature discontinuation of antipsychotic medication has the potential risk of early relapse of a severe disorder.

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