Delusional depression. Phenomenology, Neuroendocrine function, and tricyclic antidepressant response

The authors studied clinical variables, family history, cortisol secretion, and 4-week tricyclic antidepressant response in 13 delusional and 12 non-delusional, hospitalized depressives. Comparison in these parameters between the two groups revealed more family history of depression but less of alcoholism, greater frequency of cortisol hypersecretion, and poorer response to tricyclics in the delusional group. This lack of complete response was found despite full remission of delusions in 84.6% of the delusional subjects. The clinical and theoretical implications of these findings are discussed.