Other Depression with Psychotic Features
While psychotic depressions include schizoaffective disorder (19 to 21 months age-of-origin), bipolar disorder (22 months age-of-origin), other depressions with psychotic features, such as hearing voices, extend up to 24 months age-of-origin. The age specificity is striking, and age-of-origin can be determined clinically based on symptoms of the patient.
The language dysfunction of hearing voices extends from persons suffering with schizophrenia through persons with psychotic depressions.
Another patient, after a dramatic recovery, gradually deteriorated when he moved back home to take over the family business. His trauma had been at age six months when an older sibling became ill and required all of his mother’s attention. He was not delusional but was replicating a classic state of anaclitic depression or hospitalism. He could mouth words in monotone and clearly recognize, “This is not me,” but he could not recover from this state. He came out of his apartment only to drive to the office once each week. While he appeared to be making progress, he missed one appointment and then remained in his apartment. The family had to rescue him and take him to a hospital, where he was treated effectively by removing all contact with his family.
The movement into psychosis after reuniting with his family had been slow and insidious and was not immediately apparent. Once he was deep into age six months, it was too late. The psychosis that resulted was severe and lasted one full year.