A CONSENSUS CONFERENCE ON PSYCHOTIC DEPRESSION

We report a consensus conference on psychotic depression that addresse d historic, classification, phenomenologic, epidemiologic, aetiologic, management and outcome issues. We were able to detail the impact of t he information offered by having audience members complete questionnai res before and after the conference. The respondents indicated that th e status of psychotic depression (as a separate type or as a more seve re expression of depression) remains unclear; that delusions, hallucin ations and severe psychomotor disturbance have high cross-sectional di agnostic weighting (while longitudinal information is of importance); that determinants include both genetic and organic factors; that most patients with this condition require admission to hospital; and that b ilateral ECT is the most effective treatment. The answers to the quest ionnaires established areas where the audience did not modify their re sponses because they were already well-informed, others where their vi ews were considerably changed (e.g. ''psychotic'' episodes in those wi th a borderline personality disorder) and others where they modified t heir clinical reasoning (e.g. ''it a ''psychotic'' feature is mood-con gruent then the condition must be an affective disorder'' became ''it the patient has an affective disorder, the psychotic feature must be m ood-congruent''). Finally, we make some recommendations for future con sensus conferences.