Coryell W, Zimmerman M, Pfohl B
J Nerv Ment Dis. 1986 Feb;174(2):92-6. doi: 10.1097/00005053-198602000-00004.
Inpatients with nonbipolar psychotic major depression (N = 46) had significantly lower Hamilton Rating Scale scores at discharge and a significantly greater number of weeks back to their "normal selves" during a 6-month follow-up than did patients with nonpsychotic major depression (N = 159). While both baseline severity and the receipt of electroconvulsive therapy distinguished these groups, neither accounted for the outcome differences noted. Severity ratings at discharge were clearly more predictive of follow-up course in psychotic patients than they were in nonpsychotic patients. Moreover, patients with psychotic depression had clearer outcomes in that their average follow-up weeks were more likely to involve either full syndromes or a complete absence of depressive symptoms. This finding, if replicated, may account in part for the lack of consensus on the prognostic significance of psychotic depression.
患有非双相性精神病性重度抑郁症的住院患者（N = 46）在出院时的汉密尔顿评定量表得分显著更低，并且在6个月的随访期间，恢复到“正常自我”状态的周数显著多于患有非精神病性重度抑郁症的患者（N = 159）。虽然基线严重程度和接受电休克治疗这两个因素区分了这些组别，但二者均不能解释所观察到的结果差异。出院时的严重程度评分对精神病性患者随访过程的预测性明显高于对非精神病性患者的预测性。此外，精神病性抑郁症患者的结局更清晰，因为他们平均随访周数更可能涉及完全综合征或完全没有抑郁症状。这一发现若能得到重复验证，可能部分解释了在精神病性抑郁症预后意义方面缺乏共识的原因。
