A Detailed Case Study of Major Depressive Disorder with Psychotic Features in Adolescence

Abstract

This case study examines the clinical presentation, diagnostic process, and treatment approach of a 16-year-old male patient, referred to as Mr. X, diagnosed with Major Depressive Disorder (MDD) with psychotic features. The patient’s symptoms included persistent suicidal ideation, auditory hallucinations, self-injury, and marked social withdrawal, all of which progressively worsened over the span of one year. These symptoms were initially triggered by the end of a romantic relationship, but the deeper root of his depression appeared to be unresolved grief stemming from the suicide of his father. His family dynamics, characterized by ongoing dysfunction and trauma related to his father’s death, further exacerbated his condition. The treatment strategy employed in his care incorporated pharmacotherapy (including SSRIs and antipsychotic medications), psychotherapy (CBT and DBT), family therapy, and nutritional support. After engaging in this comprehensive approach, Mr. X demonstrated significant improvements in his depressive and psychotic symptoms, including a reduction in suicidal ideation, improved social and academic engagement, and a notable decline in the severity of his hallucinations. This case underscores the necessity of early recognition and a multi-faceted treatment approach in managing adolescent depression with psychotic features.