Voxel-based morphometry in patients with psychotic versus non-psychotic depression

Psychotic depression, a severe subtype of Major Depressive Disorder (MDD), involves both depressive and psychotic symptoms, leading to greater clinical and functional impairments. The purpose was to look into structural brain differences among psychotic depression, non-psychotic depression, and healthy controls using voxel -based morphometry (VBM). It also examines correlations between brain structural abnormalities and symptom severity. This cross-sectional observational study was conducted on 70 patients with a confirmed diagnosis of MDD. Patients were categorized into three groups: (group I): 25 participants diagnosed with psychotic depression, (group II): 24 participants diagnosed with non-psychotic depression, and (group III): 21 healthy controls. Using a 1.5-Tesla MR scanner, high-resolution T1-weighted MRI was used to analyze gray matter volumes in the frontal cortex, amygdala, and hippocampus. To assess symptoms of mental health issues, researchers used the Positive and Negative Syndrome Scale (PANSS), the Socioeconomic Status Scale (SES), and the Hamilton Anxiety Rating Scale (HAMA). Patients with psychotic depression exhibited reduced hippocampal volume (7.08 ± 1.3 mm³) compared to non-psychotic depression (7.65 ± 0.9 mm³) and healthy controls (8.27 ± 1.5 mm³; P = 0.038). The psychotic depression group also had smaller amygdala sizes (1.57 ± 0.3 mm³) in comparison to the healthy control group (1.91 ± 0.5 mm³; P = 0.007). Greater decreases were associated with improved PANSS (r = -0.431; P < 0.001) and HAMD (r = -0.244; P = 0.026) ratings. The frontal lobes, amygdala, and hippocampus are the areas most affected by psychotic depression. These findings emphasize the distinct neurobiological features of psychotic depression and the utility of VBM in exploring structural changes associated with symptom severity.