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Delusional Depression
Psychotic depression, also known as depressive psychosis, is a major depressive episode that is accompanied by psychotic symptoms.Hales E and Yudofsky JA, eds, The American Psychiatric Press Textbook of Psychiatry, Washington, DC: American Psychiatric Publishing, Inc., 2003 It can occur in the context of bipolar disorder or major depressive disorder. Psychotic depression can be difficult to distinguish from schizoaffective disorder, a diagnosis that requires the presence of psychotic symptoms for at least two weeks without any mood symptoms present. Unipolar psychotic depression requires that psychotic symptoms occur during severe depressive episodes, although residual psychotic symptoms may also be present in between episodes (e.g., during remission, mild depression, etc.). Diagnosis using the DSM-5 involves meeting the criteria for a major depressive episode, along with the criteria for " mood-congruent or mood-incongruent psychotic features" specifier. Signs and symptoms Peopl ...
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Psychiatry
Psychiatry is the medical specialty devoted to the diagnosis, treatment, and prevention of deleterious mental disorder, mental conditions. These include matters related to cognition, perceptions, Mood (psychology), mood, emotion, and behavior. Initial psychiatric assessment of a person begins with creating a Medical history, case history and conducting a mental status examination. Laboratory tests, physical examinations, and psychological tests may be conducted. On occasion, neuroimaging or neurophysiological studies are performed. Mental disorders are diagnosed in accordance with diagnostic manuals such as the ''International Classification of Diseases'' (ICD), edited by the World Health Organization (WHO), and the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM), published by the American Psychiatric Association (APA). The fifth edition of the DSM (DSM-5) was published in May 2013. Treatment may include psychotropics (psychiatric medicines), psychotherapy, su ...
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DSM-5
The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the '' Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiatric Association (APA). In 2022, a revised version ( DSM-5-TR) was published. In the United States, the DSM serves as the principal authority for psychiatric diagnoses. Treatment recommendations, as well as payment by health care providers, are often determined by DSM classifications, so the appearance of a new version has practical importance. However, some providers instead rely on the International Statistical Classification of Diseases and Related Health Problems (ICD), and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions. The DSM-5 is the only DSM to use an Arabic numeral instead of a Roman numeral in its title, as ...
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Tricyclic Antidepressant
Tricyclic antidepressants (TCAs) are a class of medications that are used primarily as antidepressants. TCAs were discovered in the early 1950s and were marketed later in the decade. They are named after their chemical structure, which contains three rings of atoms. Tetracyclic antidepressants (TeCAs), which contain four rings of atoms, are a closely related group of antidepressant compounds. Although TCAs are sometimes prescribed for depressive disorders, they have been largely replaced in clinical use in most parts of the world by newer antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs) and norepinephrine reuptake inhibitors (NRIs). Adverse effects have been found to be of a similar level between TCAs and SSRIs. Medical uses The TCAs are used primarily in the clinical treatment of mood disorders such as major depressive disorder (MDD), dysthymia, and treatment-resistant variants. They are also ...
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Ventricular-brain Ratio
Ventricular-brain ratio (VBR), also known as the ventricle-to-brain ratio or ventricle-brain ratio, is the ratio of total Ventricular system, ventricle area to total brain area, which can be calculated with planimetry from brain imagining techniques such as CT scans. (). . It is a common measure of ventricular dilation or cerebral atrophy in patients with traumatic brain injury or hydrocephalus ''ex vacuo''. VBR also tends to increase with age. Generally, a higher VBR means a worse prognosis for recovering from a brain injury. For example, VBR is significantly correlated with performance on the Luria-Nebraska neuropsychological battery. Studies have found people with schizophrenia have larger third ventricles and VBR. Correlational studies have found relationships between ventricle-brain ratio and binge eating and inversely with Thyroid hormone, plasma thyroid hormone concentration. See also * Sarnoff A. Mednick * Ventriculomegaly References

Behavioral neuroscience {{Psy ...
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Cortisol
Cortisol is a steroid hormone in the glucocorticoid class of hormones and a stress hormone. When used as medication, it is known as hydrocortisone. Cortisol is produced in many animals, mainly by the ''zona fasciculata'' of the adrenal cortex in an adrenal gland. In other tissues, it is produced in lower quantities. By a Circadian rhythm, diurnal cycle, cortisol is released and increases in response to Stress (biology), stress and a low Blood sugar, blood-glucose concentration. It functions to increase blood sugar through gluconeogenesis, suppress the immune system, and aid in the metabolism of calories. It also decreases bone formation. These stated functions are carried out by cortisol binding to glucocorticoid or mineralocorticoid receptors inside a cell, which then bind to DNA to affect gene expression. Health effects Metabolic response Metabolism of glucose Cortisol plays a crucial role in regulating glucose metabolism and promotes gluconeogenesis (glucose synthes ...
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Dexamethasone Suppression Test
The dexamethasone suppression test (DST) is used to assess adrenal gland function by measuring how cortisol levels change in response to oral doses or an injection of dexamethasone. It is typically used to diagnose Cushing's syndrome. The DST was historically used for diagnosing depression, but by 1988 it was considered to be "at best, severely limited in its clinical ability" for this purpose. Physiology Dexamethasone is an exogenous steroid that provides negative feedback to the pituitary gland to suppress the secretion of adrenocorticotropic hormone (ACTH). Specifically, dexamethasone binds to glucocorticoid Glucocorticoids (or, less commonly, glucocorticosteroids) are a class of corticosteroids, which are a class of steroid hormones. Glucocorticoids are corticosteroids that bind to the glucocorticoid receptor that is present in almost every vertebra ... receptors in the anterior pituitary gland, which lie outside the blood–brain barrier, resulting in regulatory mo ...
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Hypothalamic Pituitary Adrenal Axis
The hypothalamus (: hypothalami; ) is a small part of the vertebrate brain that contains a number of nuclei with a variety of functions. One of the most important functions is to link the nervous system to the endocrine system via the pituitary gland. The hypothalamus is located below the thalamus and is part of the limbic system. It forms the basal part of the diencephalon. All vertebrate brains contain a hypothalamus. In humans, it is about the size of an almond. The hypothalamus has the function of regulating certain metabolic processes and other activities of the autonomic nervous system. It synthesizes and secretes certain neurohormones, called releasing hormones or hypothalamic hormones, and these in turn stimulate or inhibit the secretion of hormones from the pituitary gland. The hypothalamus controls body temperature, hunger, important aspects of parenting and maternal attachment behaviours, thirst, fatigue, sleep, circadian rhythms, and is important in certain soc ...
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Prognosis
Prognosis ( Greek: πρόγνωσις "fore-knowing, foreseeing"; : prognoses) is a medical term for predicting the likelihood or expected development of a disease, including whether the signs and symptoms will improve or worsen (and how quickly) or remain stable over time; expectations of quality of life, such as the ability to carry out daily activities; the potential for complications and associated health issues; and the likelihood of survival (including life expectancy). A prognosis is made on the basis of the normal course of the diagnosed disease, the individual's physical and mental condition, the available treatments, and additional factors. A complete prognosis includes the expected duration, function, and description of the course of the disease, such as progressive decline, intermittent crisis, or sudden, unpredictable crisis. When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with sever ...
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Psychomotor Retardation
Psychomotor retardation involves a slowing down of thought and a reduction of physical movements in an individual. It can cause a visible slowing of physical and emotional reactions, including speech and affect. Psychomotor retardation is most commonly seen in people with major depression and in the depressed phase of bipolar disorder; it is also associated with the adverse effects of certain drugs, such as benzodiazepines. Particularly in an inpatient setting, psychomotor retardation may require increased nursing care to ensure adequate food and fluid intake and sufficient personal care. Informed consent for treatment is more difficult to achieve in the presence of this condition. Causes * Psychiatric disorders: anxiety disorders, bipolar disorder, eating disorders, schizophrenia, severe depression, etc. * Psychiatric medicines (if taken as prescribed or improperly, overdosed, or mixed with alcohol) * Parkinson's disease * Genetic disorders: Qazi–Markouizos syndrome, S ...
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Anhedonia
Anhedonia is a diverse array of deficits in hedonic function, including reduced motivation or ability to experience pleasure. While earlier definitions emphasized the inability to experience pleasure, anhedonia is currently used by researchers to refer to reduced motivation, reduced anticipatory pleasure (wanting), reduced consummatory pleasure (liking), and deficits in reinforcement learning. In the ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), anhedonia is a component of depressive disorders, substance-related disorders, psychotic disorders, and personality disorders, where it is defined by either a reduced ability to experience pleasure, or a diminished interest in engaging in previously pleasurable activities. While the ''International Statistical Classification of Diseases and Related Health Problems, Tenth Revision'' (ICD-10) does not explicitly mention anhedonia, the depressive symptom analogous to anhedonia as described in the DSM-5 ...
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Persecutory Delusion
A persecutory delusion is a type of delusional condition in which the affected person believes that harm is going to occur to oneself by a persecutor, despite a clear lack of evidence. The person may believe that they are being targeted by an individual or a group of people. Persecution delusions are very diverse in terms of content and vary from the possible, although improbable, to the completely bizarre. The delusion can be found in various disorders, being more usual in psychotic disorders. Persecutory delusion is at the more severe end of the paranoia spectrum and can lead to multiple complications, from anxiety to suicidal ideation. Persecutory delusions have a high probability of being acted upon, for example not leaving the house due to fear, or acting violently. The persecutory delusion is a common type and is more prevalent in males. Persecutory delusions can be caused by a combination of genetic (family history) and environmental (drug and alcohol use, emotional ...
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Hallucination
A hallucination is a perception in the absence of an external stimulus that has the compelling sense of reality. They are distinguishable from several related phenomena, such as dreaming ( REM sleep), which does not involve wakefulness; pseudohallucination, which does not mimic real perception, and is accurately perceived as unreal; illusion, which involves distorted or misinterpreted real perception; and mental imagery, which does not mimic real perception, and is under voluntary control. Hallucinations also differ from " delusional perceptions", in which a correctly sensed and interpreted stimulus (i.e., a real perception) is given some additional significance. Hallucinations can occur in any sensory modality— visual, auditory, olfactory, gustatory, tactile, proprioceptive, equilibrioceptive, nociceptive, thermoceptive and chronoceptive. Hallucinations are referred to as multimodal if multiple sensory modalities occur. A mild form of hallucination is known as ...
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