Psychotic Depression occurs when a severe depressive illness is accompanied by some form of psychosis, such as a break with reality, hallucinations, and delusions. Psychotic symptoms tend to develop after an individual has already had several episodes of depression without psychosis, however, once psychotic symptoms have emerged, they tend to reappear with each future depressive episode.
Those who have experienced a depressive episode with psychotic features have an increased risk of relapse and suicide compared to those without psychotic features, and they tend to have more pronounced sleep abnormalities.