Neurobiological mechanisms in postpsychotic depression

Postpsychotic depression (PPD) is a distinct form of depression that emerges following the remission of psychotic symptoms. It is unlike the negative symptoms of schizophrenia (avolition, anhedonia, alogia, blunt affect), and it does not constitute the result of medication, nor other psychotic and mood disorder diagnoses such as bipolar disorder, schizoaffective disorder, or major depressive disorder with psychotic features. PPD may affect a person’s functional recovery, recovery from relapse, and the overall quality of life. Here, we look at a clinical case, and we examine the disorder’s underpinning neurobiological mechanisms. This article aims to cover current literature regarding circuit neuroplastic pathology, neurotransmitter dysregulation and neuroendocrine dysregulation. The case study describes a psychopathological situation encountered in our clinical practice, and the discussions surrounding it incorporate data from the specialized literature indicating possible organic causes of the neurobiological instability specific to the remission of psychotic symptoms. Together with the literature, this case study emphasizes the critical need for early diagnosis and proactive, multifaceted intervention to improve the enduring recovery.