Psychotic depression represents a severe form of depression characterized by the presence of psychotic features. It is considered the most extreme manifestation of depressive disorders, with approximately one in four individuals admitted to psychiatric hospitals exhibiting this condition. Psychotic depression entails hallucinations, which can manifest as auditory or visual experiences, such as hearing voices, along with prominent delusions, such as believing one has committed a crime and is being pursued by law enforcement.
Although psychosis is also observed in other mental illnesses like schizophrenia, individuals with psychotic depression typically develop delusions or hallucinations subsequent to the onset of depression. Unlike schizophrenia, which lacks a mood component, psychotic depression is inherently linked to depressive symptoms.
Several risk factors contribute to the development of psychotic depression, including childhood trauma, experiences of sexual abuse, and advancing age (particularly in individuals aged in their 60s, 70s, and 80s). Diagnosis of psychotic depression can be challenging, as some individuals may conceal their symptoms in an attempt to present as functioning normally.