Psychotic Features in Adolescents with Major Depression

Psychotic and nonpsychotic depressed adolescent inpatients were compared on demographic features, clinical characteristics, and symptom ratings derived from the Diagnostic Interview Schedule for Children. Their patterns of demographic and clinical characteristics were similar; however, psychotic patients were more likely to have a history of sexual abuse, to be more depressed, and to have more hypomanic symptoms in their recent past than nonpsychotic patients. Those with mood-incongruent features differed from those with mood-congruent features only by the higher frequency of hypomanic episodes in their recent past. These findings suggest that psychotic features are not only a marker for severe depression but also identify mild forms of bipolar disorder. J. Am. Acad. Child Adolesc, Psychiatry, 1988, 27,4:489–493.