Minter R E, Mandel M R
J Nerv Ment Dis. 1979 Dec;167(12):726-33. doi: 10.1097/00005053-197912000-00002.
A retrospective chart review of 54 patients demonstrating depression with psychotic symptoms was accomplished with the use of Research Diagnostic Criteria (RDC) for diagnosis of psychotic major affective disorder. Patients received adequate trials of either tricyclic antidepressants alone, antipsychotics, the two in combination, or electroconvulsive therapy (ECT). Antidepressants alone were found to be ineffective or only partially effective in treating psychotic depression unless somatic or depressive declusions were the only psychotic symptoms. Antipsychotics alone were usually effective in providing at least a partial response, particularly with psychotic symptoms. Excellent responses of the depressive and psychotic elements were provided with ECT, ECT with antipsychotic medication, and the combination of antidepressant and antipsychotic medications. These latter treatments may be the most appropriate for depression with psychotic features.
对54例伴有精神病性症状的抑郁症患者进行了回顾性病历审查，采用研究诊断标准（RDC）诊断精神病性重度情感障碍。患者接受了单独使用三环类抗抑郁药、抗精神病药物、两者联合使用或电休克治疗（ECT）的充分试验。发现单独使用抗抑郁药在治疗精神病性抑郁症方面无效或仅部分有效，除非躯体或抑郁性妄想是唯一的精神病性症状。单独使用抗精神病药物通常至少能产生部分疗效，尤其是对精神病性症状。ECT、ECT联合抗精神病药物以及抗抑郁药和抗精神病药物联合使用对抑郁和精神病性症状均有良好疗效。后几种治疗方法可能最适合伴有精神病性特征的抑郁症。
