Major depressive disorder (MDD) with psychotic is a complicated affective diseasecharacterized by abnormal clinical sympotms, including neurovegetative disfunction (appetiteor sleep disturbances), cognitive dissonance (inappropriate guilt, feelings of worthlessness),aberrant psychomotor activities (agitation or retardation), and elevated suicide risk withpsychotic features such as delusions or nihilistic, non-bizarre delusions, somatic, poverty,worthlessness, or delusional beliefs about guilt and being punished, and sometimes appearhallucination. The prevalence of MDD with psychotic features increases with age. In generalpopulation, the point prevalence of MDD is about 2% to 4% and it is increasing about 20%lifetime risk. Depression is a leading cause of burden of disease among young people. Currenttreatments are not uniformly effective, in part due to the heterogeneous nature of MDD. MDDis caused by many factors. A 22-year-old male presented to the inpatient psychiatric unit withsuicide attempt. The patient reported experiencing a lack of energy, difficulty falling asleep,lack of motivation, and feeling overwhelmed about his work and experiencing auditorichallucination. The insight level was 5. Multiaxial diagnosis are axis I: major depressive episodewith psychotic symptoms; axis II and III: currently not found; axis IV: problems withworkplace; axis V: GAF 20-11. Patient treated with pharmacotherapy group SelectiveSerotonin Reuptake Inhibitor (SSRI) and second-generation antipsychotics which combinedwith supportive psychotherapy such as mindfullness. DOI : 10.35990/amhs.v1n1.p45-53