Guideline 7: Psychotic Major Depressive Disorder

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To diagnose psychotic major depression in an older patient, the experts required the presence of both delusions and thefollowing three key depressive symptoms: depressed mood, most of the day, every day, markedly diminished interest orpleasure in activities, and recurrent thoughts of death or suicidal ideation or behavior (see Guideline 6A).

The treatment of choice for psychotic major depression in an older patient was an antipsychotic plus an antidepressant, which was rated first line by 98% of the experts.’ ‹’ ‹