Symptoms of atypical depression

Studies examining the demographic and clinical features of depressed patients who meet criteria for the atypical features subtype have often yielded conflicting results. The present study sought to evaluate the demographic and clinical correlates associated with each of the five symptoms (mood reactivity, hypersomnia, hyperphagia, leaden paralysis and rejection sensitivity) that constitute the DSM-IV criteria set of atypical depression. Symptom prevalence rates were determined for 661 psychiatric outpatients diagnosed with a major depressive disorder, and were analyzed as a function of age, sex, severity, and episode duration. We found that: (1) younger age was positively associated with hypersomnia and negatively associated with leaden paralysis, while middle age was positively associated with both hyperphagia and rejection sensitivity; (2) female sex was associated with all of the atypical symptoms except rejection sensitivity; (3) a greater severity of illness was positively associated with leaden paralysis and rejection sensitivity, and negatively associated with mood reactivity; and (4) a duration of illness of greater than 3 months was positively associated with hyperphagia, leaden paralysis, and rejection sensitivity. Thus, the five atypical features do not appear to be associated with the same clinical profiles.