University of Oulu

Miika Nietola, Anni Heiskala, Tanja Nordström, Jouko Miettunen, Jyrki Korkeila, Erika Jääskeläinen, Clinical characteristics and outcomes of psychotic depression in the Northern Finland Birth Cohort 1966, European Psychiatry, Volume 53, 2018, Pages 23-30, ISSN 0924-9338,

Clinical characteristics and outcomes of psychotic depression in the Northern Finland Birth Cohort 1966

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Author: Nietola, Miika1; Heiskala, Anni2; Nordström, Tanja2,3;
Organizations: 1Psychiatric Department, University of Turku and the Hospital District of Southwest Finland, Finland
2Center for Life Course Health Research, University of Oulu, Oulu, Finland
3Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
4Psychiatric Department, University of Turku and Satakunta Hospital District, Finland
5Department of Psychiatry, Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 1.5 MB)
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Language: English
Published: Elsevier, 2018
Publish Date: 2019-05-30


Background: Psychotic depression (PD) is heavily understudied despite high mortality and the severe course of illness. A majority of the studies conducted so far are also largely based on selected clinical samples. The aim of this study was to examine the clinical characteristics of PD in a representative prospective birth cohort sample.

Methods: The Northern Finland Birth Cohort 1966 is a well-known prospective population-based cohort including 12 058 people followed since mid-pregnancy. We identified 55 individuals with PD, analysed their characteristics and compared them with schizophrenia (SZ), non-psychotic depression (NPD), psychotic bipolar disorder (PBD) and other psychoses (PNOS).

Results: The life-time prevalence of stable (no conversion to schizophrenia, bipolar disorder or schizoaffective disorder) PD was 0.5%. PD subjects were older than SZ and PNOS subjects during the first psychotic episode and compared to SZ, more often female. PD required hospitalization and transition to disability pension more often than NPD, but less often than SZ. Comorbid alcohol abuse disorder (44%) and personality disorder (40%) were highly common in PD. PNOS had a similar occupational outcome than PD but hospitalization rate was lower in the PNOS group. PBD and PD had mostly comparable outcomes.

Conclusions: Our findings in a naturalistic cohort support the notion that the course of illness in PD is mostly similar to that of PBD, it is less severe than in schizophrenia, but worse than in non-psychotic depression. PD seems to have high psychiatric comorbidity.

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Series: European psychiatry
ISSN: 0924-9338
ISSN-E: 1778-3585
ISSN-L: 0924-9338
Volume: 53
Pages: 23 - 30
DOI: 10.1016/j.eurpsy.2018.05.003
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
Funding: This work was supported by grants from the Academy of Finland (grant numbers 278 286, 268 336), the Sigrid Jusélius Foundation, the Brain & Behavior Research Foundation.
Academy of Finland Grant Number: 278286
Detailed Information: 278286 (Academy of Finland Funding decision)
268336 (Academy of Finland Funding decision)
Copyright information: © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license