<![CDATA[Major depressive disorder (MDD) with psychotic is a complicated affective disease characterized by abnormal clinical sympotms, including neurovegetative disfunction (appetite or sleep disturbances), cognitive dissonance (inappropriate guilt, feelings of worthlessness), aberrant psychomotor activities (agitation or retardation), and elevated suicide risk with psychotic features such as delusions or nihilistic, non-bizarre delusions, somatic, poverty, worthlessness, or delusional beliefs about guilt and being punished, and sometimes appear hallucination. The prevalence of MDD with psychotic features increases with age. In general population, 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. Current treatments 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 with suicide attempt. The patient reported experiencing a lack of energy, difficulty falling asleep, lack of motivation, and feeling overwhelmed about his work and experiencing auditoric hallucination. The insight level was 5. Multiaxial diagnosis are axis I: major depressive episode with psychotic symptoms; axis II and III: currently not found; axis IV: problems with workplace; axis V: GAF 20-11. Patient treated with pharmacotherapy group Selective Serotonin Reuptake Inhibitor (SSRI) and second-generation antipsychotics which combined with supportive psychotherapy such as mindfullness. DOI : 10.35990/amhs.v1n1.p45-53 REFERENCES Brown, K. W., & Ryan, R. M. (2004). Perils and promise in defining and measuring mindfulness: Observations from experience. Clinical Psychology: Science and Practice, 11, 242–248. Ohayon, M. M., & Schatzberg, A. F. (2002). 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