Prevalence and clinical correlates of psychotic symptoms and its association with Internet addition symptoms in adolescents with major depressive disorder

Abstract

Abstract Aim Psychotic symptoms in patients with major depressive disorder (MDD) have been associated with a worse clinical course, although previous studies reported substantial heterogeneity. Despite the relevance of the subject, the relationship between psychotic symptoms and socio-demographic and clinical characteristics of adolescent patients with MDD is not clear.Methods We screened 195 adolescents with MDD, and after excluding cases with changes in diagnosis or incomplete clinical data during the subsequent six months of follow-up, we included 161 cases to investigate the relationship between psychotic symptoms and clinical characteristics. According to the presentation of psychotic symptoms, patients were categorized into PD and NPD groups. Independent sample t-tests and chi-square tests were employed to compare these two groups. Binary logistic regression analysis was conducted to assess socio-demographic and clinical risk factors associated with psychotic symptoms.Results The prevalence of psychotic symptoms in these MDD adolescents was 27.3%. The scores of BMI, HAMD and IAT of MDD adolescents with psychotic symptoms were significantly higher than those of MDD adolescents without psychotic symptoms (both p < 0.05). A strong association was found between psychotic symptoms and suicide, with odds ratio of 4.012 for suicide.Conclusions These findings suggest that the psychotic symptoms of adolescents with MDD are closely related to Internet addiction and suicide attempts. It is crucial to address the occurrence of internet addiction symptoms when treating these patients, while also regularly assessing their suicidal attempts to effectively prevent self-harm.