الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
The aim of the work is to test the following hypotheses through a clinical comparative study inside and a cross cultures:
* Hypotheses 1: major depression with psychotic features could be a distinct entity in comparison with major depression without psychotic features.
These two types may be different as regards:
a- Prodromal phase.
b- Full episode including:
- Severity of depressive episode.
- Duration of depressive episode.
- Characteristic symptomatology.
- Personality dysfunction.
c- Rate of recovery and rate of recurrence.
* Hypothesis 2: major depressive disorder with and without psychotic features may differ from culture to culture.
* Hypothesis 3: the expected discriminating differences which can separate between major depression with and without psychotic features inside one culture may differ from culture to culture.
Conclusions:
1- Inspite that many data (prodroma, characteristics symptoms particularly in full episode and post episode including residual symptoms, rate of recovery and rate of recurrence) strongly suggest that major depression with psychotic features is a disorder that can be differentiated from unipolar major depression without psychotic features. Still, a number of questions can and should be raised about a separate designation.
2- Cultural variations of psychopathology and symptoms coloration should be taken into account more seriously than before. As cultural conventions about the self and pattern of emotional expression make universal criteria of psychiatric nosology problematical.
3- Still incidence of delusions is more common than hallucinations and persecutory delusions are the most common delusion also, our study revealed that psychotic depressive patients, in contrast to those reported in western studies, had more hallucinations than expected and auditory is the commonest.
4- Few presentation of delusions of guilt especially in Kuwaiti was observed and this difference in common type of delusions between our study and western reports may stem from differences in the concept of self and attribution processes.
5- Inspite methodological limitations, our results suggested that there were meaningful differences in symptom presentation in psychotic depression across cultures for example irritability, anxiousness, and angry are more prominent in Kuwaiti patient in general.
6- Results of history data from clinical sheet were supported by results from psychometric studies especially in areas of prodromal study, delusions and hallucinations.
7- As regard presentation, frequency and changes across course of treatment, reduction and persistence of delusions and hallucinations were of no significant value.
8- We observed relative greater impairment of insight in psychotic depression versus non psychotic depression which affect prognosis.