Psychotic Symptoms in Prepubertal Major Depressive Disorder

Symptoms of psychosis and psychoticlike phenomena were systematically inquired for, using a semistructured diagnostic interview protocol, in 58 prepubertal children who fulfilled Research Diagnostic Criteria for major depressive disorder. Subjects were classical into endogenous and nonendogenous subtypes. Forty-eight percent of the sample reported hallucinations. Thirty-six percent (including 48% of those in the endogenous subtype and 24% of those in the nonendogenous subtype) reported auditory hallucinations that consisted of one or more words other than their names, experienced in clear consciousness. Sixteen percent reported visual or tactile hallucinations. Four children were rated as having delusional ideas. Symptoms were analyzed in terms of contents, formal characteristics, thematic and temporal consistency with depressed mood, extent of the child's belief in the reality of the experience, frequency, and experienced location of auditory hallucinations. The psychopathologic meaning of the reported phenomena is uncertain.