Psychotic depression in older adults following the sudden loss of a spouse during the COVID-19 pandemic: a case series

Background. Little is known about the relationship between sudden loss, social isolation, and onset of major depressive disorder (MDD) with psychotic features. We report two cases of MDD with psychotic features that developed in older women after the sudden loss of a spouse in the setting of social isolation in the COVID-19 pandemic. Case reports. Both women were brought to stay with family after their symptoms were discovered. Both experienced remission of symptoms on the combination of an antidepressant and a relatively low dose of risperidone (1.5-2 mg daily). Neuropsychological assessments were typical of normal ageing. Conclusions. These cases suggest that unexpected loss and social isolation may precipitate psychotic depression, and providers may want to recommend social engagement for older adults experiencing bereavement.