Depression with and without a history of psychotic symptoms in the general population: sociodemographic and clinical characteristics

Background:: The aim of this study was to find the sociodemographic and clinical characteristics of major depressive episode (MDE) with (MDE-HPS+) and without a history of psychotic symptoms (MDE-HPS) in the general population. Methods:: The Mental Health in the General Population survey interviewed 38,694 individuals in France by using the MINI. The prevalence and sociodemographic and clinical correlates of MDE-HPS+ were assessed. Results:: Of the sample, 11.2% were diagnosed with current MDE and among them, 39.3% presented a history of at least one psychotic symptom (hallucination or delusion). Patients with MDE-HPS+ were younger with more severe social impairment than those with MDE-HPS-. We also found a higher proportion of three generations of migrants in the MDE-HPS+ group. Comorbid psychiatric disorders such as a history of a manic episode, alcohol use disorder, social anxiety, generalized anxiety disorder, and a personal history of a suicide attempt were more frequent in patients with MDE-HPS+ than in those with MDE-HPS-. Finally, we found a specific gradient of severity for psychiatric comorbid disorders depending on the number of psychotic symptoms lifetime in MDE. Limitations:: The study also has an observational cross-sectional design that does not permit causal inferences, and it is difficult to eliminate recall bias and reporting errors. Conclusion:: In the general population, patients with MDE-HPS+, when compared to MDE-HPS-, presented with a more severe clinical profile, with increased rates of psychiatric comorbidities, particularly a history of bipolar disorder and a history of a suicide attempt. © 2020 Elsevier B.V.