Prevalence, clinical importance and validation of atypical depression

Summary

Background: The objective was to assess thefrequency of atypical depression (AD) in depressedinpatients; to compare clinical featuresof patients with atypical and nonatypical depression(Non-AD) and to evaluate the meaningof single psychopathological symptomswith special respect to mood reactivity. Method: Diagnoses were assessed accordingto DSM-IV using SCID and AMDP. Diagnosis ofatypical depression was defined according tocriteria of the DSM-IV specifier for AD. All patientswere rated using HAMD-21. Results: Ahigh percentage of patients met criteria forAD. Women were more likely to suffer fromAD. There were no significant differences betweenAD and Non AD patients regarding age,HAMD total baseline score, and diagnosis ofany bipolar illness. In terms of psychopathologypatients with AD were significantly morelikely to suffer from somatic anxiety, somaticsymptoms, guilt, genital symptoms, depersonalisationand suspiciousness as defined byHAMD-21 items. Interestingly, mood reactivitywas not found to be significantly associatedwith the presence of two or more additionalsymptoms of AD. Conclusion: Frequencyof AD may be underestimated, especially in inpatientsamples. Further studies of inpatientsamples are recommended. Quality of distinctanxiety symptoms may be different in bothgroups, with AD patients being more likely tosuffer from somatic symptoms and somaticanxiety.

Keywords

Atypical depression - bipolar disorder - anxiety,inpatients - depression

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