Studied the occurrence of delusional depression over an 8-yr period in a psychiatric practice in TunisiDelusional depression according to Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria was found in 73 Ss (54% male and 46% female) with a mean age of 36.5 yrs. Diagnosis on Axis 1 showed 35 cases of isolated and 21 cases of recurrent major depressive disorders and 17 cases of bipolar disorders. Delusions of persecution were found in 48% of cases, hallucinations occurred in 31.5% of cases, and delusions of guilt were present in 31% of cases. From 1991 to 1998 there was a marked increase in guilt feelings.