Jeste D V, Heaton S C, Paulsen J S, Ercoli L, Harris J, Heaton R K
Department of Psychiatry, University of California, San Diego, USA.
Am J Psychiatry. 1996 Apr;153(4):490-6. doi: 10.1176/ajp.153.4.490.
This study compared the clinical and neuropsychological characteristics of patients with psychotic depression to those of patients with nonpsychotic depression and patients with schizophrenia.
Two hundred eighteen patients over the age of 45, including 30 who met the DSM-III-R criteria for unipolar major depression with psychotic features, 28 with nonpsychotic unipolar major depression, and 160 with schizophrenia, were examined. Subjects were evaluated on several clinical measures as well as on neuropsychological tests of attention, learning, memory (retention), psychomotor speed, and motor skills.
The three groups were comparable in age and education. The severity of depressive symptoms in the depressed patients with and without psychosis was similar. The patients with psychotic depression were comparable to those with schizophrenia on the neuropsychological measures; they were more impaired than the patients with nonpsychotic depression on the measures of psychomotor speed, motor skills, attention, and learning. The cognitive deficits seemed to be trait-related.
The findings provide additional support for the validity of psychotic depression as a diagnostic category distinct from nonpsychotic depression.
本研究比较了伴有精神病性症状的抑郁症患者与非精神病性抑郁症患者及精神分裂症患者的临床和神经心理学特征。
对218名45岁以上的患者进行了检查，其中包括30名符合DSM-III-R标准的伴有精神病性特征的单相重度抑郁症患者、28名非精神病性单相重度抑郁症患者和160名精神分裂症患者。对受试者进行了多项临床评估以及注意力、学习、记忆（保持）、心理运动速度和运动技能的神经心理学测试。
三组在年龄和教育程度上具有可比性。有和没有精神病性症状的抑郁症患者的抑郁症状严重程度相似。伴有精神病性症状的抑郁症患者在神经心理学指标上与精神分裂症患者相当；在心理运动速度、运动技能、注意力和学习指标上，他们比非精神病性抑郁症患者受损更严重。认知缺陷似乎与特质相关。
这些发现为伴有精神病性症状的抑郁症作为一种与非精神病性抑郁症不同的诊断类别提供了更多支持。
