Analysis of clinical features and its influencing factors of depression patients with and without psychotic symptoms

Objective To analyze the clinical features and its influencing factors of depression patients with and without psychotic symptoms. Methods According to the presence of psychotic symptoms, 374 patients with major depression were divided into psychotic major depression (PMD group, 79 case) and nonpsychotic major depression (NMD group, 268 case). All patients completed social demographic questionnaire (including gender, age, marital status, educational level, family history, positive family history of psychiatric disorder, disease onset age, frequency of attack, times of hospitalization, etc.) and Hamilton's depression scale (HAMD-24). Results Positive family history(PMD group 47/79, NMD group 104/268, P<0.01), psychiatric disorder positive family history(PMD group 19/79, NMD group 26/268, P<0.01) and times of hospitalization(PMD group(2.52±1.29), NMD group(1.39±1.31), P<0.01) in the PMD group were significantly higher than the NMD group.HAMD total scores(PMD total score(47.85±8.69), NMD total score(43.44±8.51), P<0.01), the factor score of anxiety/somatization(PMD group(11.40±3.28), NMD group(9.19±3.54), P<0.01) and cognitive impairment(PMD group(12.24±3.77), NMD group(9.45±3.68), P<0.01) in the PMD group were significantly higher than the NMD group.Disease onset age(PMD group(30.09±5.17), NMD group(35.95±9.06), P<0.01), the course of the disease(PMD group(1.58±0.76), NMD group(3.02±2.87), P<0.01), the factor score of day and night change(PMD group(0.76±0.46), NMD group(1.01±0.51), P<0.01) in PMD group were significantly lower than the NMD. Logistic regression analysis showed the major depression with positive family history of mental disorders(β=3.278), attack in early age(β=-2.524), seriously cognitive dysfunction in patients(β=3.836) may indicate the psychotic symptoms(P<0.05). Conclusion PMD patients more positive family history, psychiatric disorder positive family history, likely to be hospitalization, severe symptoms and attack in early age compared with NMD. With positive family history of mental disorders, attack in early age, seriously cognitive dysfunction in patients with major depression may indicate the psychotic symptoms. Key words: Depression; Psychotic symptoms; Clinical features