Friday, March 16, 2012

Psychosis-Like Symptoms in Some Depressed Patients Call for New Approach

When is psychosis not psychosis? Perhaps when psychosis-like symptoms show up in depressed patients from a specific ethnic group.
A review of 37 published articles found that 22% to 46% of depressed Latino patients experience atypical psychotic symptoms such as mild auditory or visual hallucinations, or paranoia, wrote psychiatrists Paolo Cassano, M.D., Ph.D., Maurizio Fava, M.D., and David Mischoulon, M.D., Ph.D., of Massachusetts General Hospital in the March 15 Psychiatric Services in Advance. Just 9.5 percent of Latinos in general have those symptoms during their lifetimes. Psychosis-like symptoms were associated with more medical and psychiatric illness, as well as greater suicidality, functional impairment, and utilization of services.
So should clinicians treating depressed Latino patients augment antidepressants with an antipsychotic? The . . . atypical psychotic symptoms experienced by Latinos with major depressive disorder are nonpsychotic manifestations, and antipsychotic medication should be delayed unless treatment of depression fails to address the psychosis-like symptoms,” the authors concluded.

For more in Psychiatric News about ethnic and cultural factors in psychiatry, click here.
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