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Which clinical factors and biochemical parameters differentiate major depressive disorder with versus without lifetime psychotic symptoms?

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Title: Which clinical factors and biochemical parameters differentiate major depressive disorder with versus without lifetime psychotic symptoms?
Authors: Esposito, Cecilia Maria (AUTHOR), Legnani, Francesca (AUTHOR), Barkin, Jennifer L. (AUTHOR), Ceresa, Alessandro (AUTHOR), Nosari, Guido (AUTHOR), Di Paolo, Martina (AUTHOR), Cirella, Luisa (AUTHOR), Surace, Teresa (AUTHOR), Tagliabue, Ilaria (AUTHOR), Capuzzi, Enrico (AUTHOR), Dakanalis, Antonios (AUTHOR), Clerici, Massimo (AUTHOR), Buoli, Massimiliano (AUTHOR)
Source: International Journal of Psychiatry in Clinical Practice. Jun2026, Vol. 30 Issue 2, p172-179. 8p.
Subjects: Diagnosis of mental depression, Clinical medicine, Leukocytes, Substance abuse, Differential diagnosis, Erythrocytes, T-test (Statistics), Disease duration, Key performance indicators (Management), Hospital care, Hemoglobins, Logistic regression analysis, Retrospective studies, Lymphocytes, Descriptive statistics, Chi-squared test, Bilirubin, Blood platelets, Odds ratio, Suicidal behavior, Medical records, Acquisition of data, Statistics, Psychoses, Data analysis software, Confidence intervals, Albumins, Length of stay in hospitals, Psychological tests, Biomarkers, Mental depression, C-reactive protein, Comorbidity, Hypothyroidism, Diabetes
Geographic Terms: Italy
Abstract: Objective: Major depressive disorder (MDD) is a prevalent disabling condition, with psychotic features complicating its course and management. Purpose of the study is to identify clinical and biochemical factors differentiating psychotic from non-psychotic MDD. Methods: This is a retrospective single-centre study conducted on patients hospitalised between 2002 and 2022 at Fondazione IRCCS Policlinico (Milan, Italy) with a diagnosis of MDD. A large set of clinical and biochemical variables was collected on the first day of hospitalisation. Patients were divided according to the presence or absence of lifetime psychotic symptoms and compared by Student's t-test for continuous variables and Chi-square tests for categorical ones. The statistically significant continuous variables were inserted in a binary logistic regression model as independent predictors of lifetime psychotic symptoms. Results: No statistically significant differences in biochemical parameters (p > 0.05) were found in the two groups. The logistic regression model showed that depressed patients with lifetime psychotic symptoms had a significant longer duration of hospitalisation (p = 0.007), more lifetime suicide attempts (p = 0.035) and higher BPRS scores (p = 0.004) than the counterpart. Conclusions: Lifetime psychotic symptoms confer a more severe course of illness in patients with MDD. No biochemical parameter resulted as a biomarker of MDD psychotic subtype. KEY POINTS: Patients with MDD who experience lifetime psychotic symptoms seem to be affected by a less favourable illness course than the ones who don't, as pointed out by longer duration of hospitalisation, more lifetime suicide attempts and higher BPRS scores. Poly-substance use disorders and a positive family history for psychiatric disorders are more frequently associated with MDD patients that present psychotic symptoms during life than patients who don't, this suggesting a role of these two factors in determining vulnerability to a more severe course of MDD. As far as this study has investigated, psychotic symptoms do not seem to affect biochemical parameters in patients with MDD: no peripheral biomarker has shown to differentiate depressed patients with or without lifetime psychotic symptoms; nevertheless, current literature provides little data concerning this question. Considering the limitations of a single-centre retrospective study, further research is needed to confirm these results. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Objective: Major depressive disorder (MDD) is a prevalent disabling condition, with psychotic features complicating its course and management. Purpose of the study is to identify clinical and biochemical factors differentiating psychotic from non-psychotic MDD. Methods: This is a retrospective single-centre study conducted on patients hospitalised between 2002 and 2022 at Fondazione IRCCS Policlinico (Milan, Italy) with a diagnosis of MDD. A large set of clinical and biochemical variables was collected on the first day of hospitalisation. Patients were divided according to the presence or absence of lifetime psychotic symptoms and compared by Student's t-test for continuous variables and Chi-square tests for categorical ones. The statistically significant continuous variables were inserted in a binary logistic regression model as independent predictors of lifetime psychotic symptoms. Results: No statistically significant differences in biochemical parameters (p > 0.05) were found in the two groups. The logistic regression model showed that depressed patients with lifetime psychotic symptoms had a significant longer duration of hospitalisation (p = 0.007), more lifetime suicide attempts (p = 0.035) and higher BPRS scores (p = 0.004) than the counterpart. Conclusions: Lifetime psychotic symptoms confer a more severe course of illness in patients with MDD. No biochemical parameter resulted as a biomarker of MDD psychotic subtype. KEY POINTS: Patients with MDD who experience lifetime psychotic symptoms seem to be affected by a less favourable illness course than the ones who don't, as pointed out by longer duration of hospitalisation, more lifetime suicide attempts and higher BPRS scores. Poly-substance use disorders and a positive family history for psychiatric disorders are more frequently associated with MDD patients that present psychotic symptoms during life than patients who don't, this suggesting a role of these two factors in determining vulnerability to a more severe course of MDD. As far as this study has investigated, psychotic symptoms do not seem to affect biochemical parameters in patients with MDD: no peripheral biomarker has shown to differentiate depressed patients with or without lifetime psychotic symptoms; nevertheless, current literature provides little data concerning this question. Considering the limitations of a single-centre retrospective study, further research is needed to confirm these results. [ABSTRACT FROM AUTHOR]
ISSN:13651501
DOI:10.1080/13651501.2025.2611928