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BMC Psychiatry
Published in: BMC Psychiatry 1/2024

Open Access 01-12-2024 | Mood Disorders | Research

Prevalence and risk factors for psychotic symptoms in young, first-episode and drug-naïve patients with major depressive disorder

Authors: Yuxuan Wu, Xueli Zhao, Zhe Li, Ruchang Yang, Ruijie Peng, Yue Zhou, Xingzhi Xia, Hanxu Deng, Xiaobin Zhang, Xiangdong Du, Xiangyang Zhang

Published in: BMC Psychiatry | Issue 1/2024

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Abstract

Background

Major depressive disorder (MDD) is a common psychiatric disorder worldwide. Psychotic depression has been reported to be frequently under-diagnosed due to poor recognition of psychotic features. Therefore, the purpose of this study was to reveal the rate and risk factors of psychotic symptoms in young, drug-naïve patients with major depressive disorder at the time of their first episode.

Methods

A total of 917 patients were recruited and divided into psychotic and non-psychotic subgroups based on the Positive and Negative Syndrome Scale (PANSS) positive subscale score. Anxiety symptoms and depressive symptoms were measured by the Hamilton Anxiety Rating Scale (HAMA) and the 17-item Hamilton Depression Rating Scale (HAMD-17), respectively. Several biochemical indicators such as total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were also measured.

Results

The rate of psychotic symptoms among young adult MDD patients was 9.1%. There were significant differences in TSH (p<0.001), FBG (p<0.001), TC (p<0.0001), TG (p = 0.001), HDL-C (p = 0.049), LDL-C (p = 0.010), diastolic blood pressure (DP) (p<0.001), systolic blood pressure (SP) (p<0.001), and HAMD total score (p<0.001) between young MDD patients with and without psychotic depression. HAMD, TSH, TC, and severe anxiety were independently associated with psychotic symptoms in young adult MDD patients. In addition, among young MDD patients, the rate of suicide attempts in the psychotic subgroup was much higher than in the non-psychotic subgroup (45.8% vs. 16.9%).

Conclusions

Our findings suggest that psychotic symptoms are common in young MDD patients. Several clinical variables and biochemical indicators are associated with the occurrence of psychotic symptoms in young MDD patients.
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Metadata
Title
Prevalence and risk factors for psychotic symptoms in young, first-episode and drug-naïve patients with major depressive disorder
Authors
Yuxuan Wu
Xueli Zhao
Zhe Li
Ruchang Yang
Ruijie Peng
Yue Zhou
Xingzhi Xia
Hanxu Deng
Xiaobin Zhang
Xiangdong Du
Xiangyang Zhang
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2024
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-024-05517-5

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