ICD-10

ICD-10 Classification of Mental and Behavioural Disorders, World Health Organization, Geneva, 1992

A severe depressive episode which meets the criteria given for severe depressive episode without psychotic symptoms and in which delusions, hallucinations, or depressive stupor are present. The delusions usually involve ideas of sin, poverty, or imminent disasters, responsibility for which may be assumed by the patient. Auditory or olfactory hallucinations are usually of defamatory or accusatory voices or of rotting filth or decomposing flesh. Severe psychomotor retardation may progress to stupor. If required, delusions or hallucinations may be specified as mood-congruent or mood-incongruent.

Depressive stupor must be differentiated from catatonic schizophrenia, from dissociative stupor, and from organic forms of stupor. This category should be used only for single episodes of severe depression with psychotic symptoms; for further episodes a subcategory of recurrent depressive disorder should be used.

* single episodes of major depression with psychotic symptoms, psychotic depression, psychogenic depressive psychosis, reactive depressive psychosis

DCR-10 Criteria

A. The general criteria for depressive episode must be met
B. The criteria for severe depressive episode without psychotic symptoms (F32.2) must be met with the exception of criterion D
C. The criteria for schizophrenia or schizoaffective disorder, depressive type are not met
D. Either of the following must be present:

1. delusions or hallucinations, other than those listed as typically schizophrenic (i.e. delusions other than those that are completely impossible, or culturally inappropriate, and hallucinations that are not in the 3rd person or giving a running commentary); the commonest examples are those with depressive, guilty, hypochondriacal, nihilistic, self-referential or persecutory content
2. depressive stupor