The prognostic importance of delusions in depression: a 6-year prospective follow-up study

The authors followed 32 delusional and 41 unipolar non-delusional depressed patients 6 years after hospital discharge. Long-term outcome, as determined by the frequency of the relapses, number of hospitalizations, chronic course of illness as well as clinical status and global functioning at the end of the 6-year period, failed to differentiate the two patient groups. Discontinuation of maintenance medication in both groups or of antipsychotics in the delusional group was associated with a high rate of relapses. Our findings indicate that delusional depression has a similar clinical course to that of non-delusional depression, underline the importance of psychoprophylactic treatment and question the efficacy of monotherapy with antidepressants in the prevention of relapses of delusional depression.