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Depression With Atypical Features: Diagnostic Validity, Prevalence, and Treatment
1Department of Therapeutics, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York.
Primary Care Companion to the Journal of Clinical Psychiatry
|March 12, 2004
Summary
Depression with atypical features is a common, treatable subtype of depression. Patients show good response to antidepressant treatment, particularly monoamine oxidase inhibitors.
Area of Science:
- Psychiatry
- Clinical Psychology
Background:
- Depression with atypical features is a common subtype of depression in outpatients.
- Evidence suggests it's a biologically distinct subtype.
- The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) includes this specifier.
Purpose of the Study:
- To summarize the characteristics and treatment of depression with atypical features.
- To highlight its biological distinctiveness and treatment response.
Main Methods:
- Review of existing literature and diagnostic criteria (DSM-IV).
- Analysis of genetic epidemiologic studies.
- Comparison of treatment responses to different antidepressant classes.
Main Results:
- Key symptoms include overeating, hypersomnia, leaden paralysis, and rejection sensitivity.
- Patients exhibit mood reactivity.
- Preferential response to monoamine oxidase inhibitors over tricyclic antidepressants observed.
Conclusions:
- Depression with atypical features is a distinct, treatable subtype.
- Antidepressant treatment, especially MAOIs, is effective.
- Despite behavioral similarities, it responds well to therapy.