Name of the Condition

• Major depressive disorder, recurrent, severe with psychotic symptoms
• Also referred to as: recurrent major depression with psychotic features

Summary

• Major depressive disorder, recurrent, severe with psychotic symptoms (F33.3) is a mental health condition characterized by repeated episodes of deep depression accompanied by psychotic features such as hallucinations or delusions.

Causes

• The exact causes are not fully understood but may include a combination of genetic, biological, environmental, and psychological factors. Neurotransmitter imbalances in the brain and stressful life events can also contribute to its development.

Risk Factors

• Family history of depression or other mental health disorders
• Chronic medical conditions
• Substance abuse
• Experiencing trauma or significant life stressors

Symptoms

• Persistent feelings of sadness or hopelessness
• Lack of interest in activities once enjoyed
• Changes in appetite or weight
• Sleep disturbances
• Fatigue or loss of energy
• Difficulty concentrating
• Presence of hallucinations or delusions

Diagnosis

• Comprehensive psychiatric evaluation
• Clinical interviews and assessment tools like the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria
• Often involves ruling out other mental health disorders and medical conditions

Treatment Options

• Antidepressant and antipsychotic medications to manage symptoms
• Psychotherapy, such as cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT)
• Electroconvulsive therapy (ECT) for severe cases that do not respond to medication
• Combination of medication and therapy is often most effective

Prognosis and Follow-Up

• With appropriate treatment, many individuals improve significantly; however, it may require long-term management
• Regular follow-up with mental health professionals is crucial to monitor symptoms and prevent relapse

Complications

• Increased risk of suicide and self-harm
• Social isolation or relationship issues
• Impaired ability to perform daily activities or maintain employment

Lifestyle & Prevention

• Maintaining a balanced diet and regular exercise
• Stress management techniques such as mindfulness or meditation
• Avoiding alcohol and recreational drugs
• Seeking early treatment for symptoms

When to Seek Professional Help

• If experiencing persistent depressive symptoms that interfere with daily life
• Any signs of psychosis or suicidal thoughts
• Immediate help should be sought if there are concerns about harming oneself or others

Additional Resources

• National Institute of Mental Health (NIMH)
• American Psychiatric Association (APA)
• Depression and Bipolar Support Alliance (DBSA)

Tips for Medical Coders

• Ensure the specification of "recurrent" and "severe with psychotic symptoms" when coding
• Double-check for concurrent conditions that might be present
• Avoid coding errors by verifying the clinical diagnosis corresponds to DSM-5 criteria and documentation