Insular cortex abnormalities in psychotic major depression: Relationship to gender and psychotic symptoms

► Insular sub-regional volumes were measured in psychotic major depression. ► Posterior insular volumes were reduced in PMD compared to healthy controls. ► Depressive symptoms did not correlate with any insular region-of-interest. ► Positive and overall psychotic symptoms correlated with left anterior insula. ► Changes in anterior and posterior insular morphometry distinguish PMD from non PMD.