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Atypical depression: clinical aspects and noradrenergic function
G M Asnis1, L K McGinn, W C Sanderson
1Department of Psychiatry, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY 10467.
The American Journal of Psychiatry
|January 1, 1995
Summary
Atypical depression, characterized by mood reactivity and specific symptoms, affects 29% of depressed outpatients. This subtype may involve a less impaired norepinephrine system compared to nonatypical depression.
Area of Science:
- Psychiatry and Behavioral Sciences
- Neuroscience
Background:
- Atypical depression is a specifier for depressive disorders.
- Its prevalence and biological underpinnings require further investigation.
Purpose of the Study:
- To determine the frequency of atypical depression in a cohort of depressed outpatients.
- To compare the clinical and biological characteristics of patients with atypical versus nonatypical depression.
Main Methods:
- 114 depressed outpatients were diagnosed using the Schedule for Affective Disorders and Schizophrenia (SADS).
- Atypical depression was identified using the Atypical Depressive Disorder Scale, defined by mood reactivity plus specific associated features.
- Cortisol response to desipramine was assessed to evaluate biological functioning.
Main Results:
- 29% of patients met criteria for atypical depression; this group was more likely to be female.
- No significant differences were found in SCL-90 scores between atypical and nonatypical depression groups.
- Patients with atypical depression showed a distinct cortisol response to desipramine, suggesting a potentially less impaired norepinephrine system.
Conclusions:
- Atypical depression presents a unique symptom profile and may be prevalent.
- Findings suggest atypical depression might be associated with a less impaired biological system compared to nonatypical depression.
- The data support considering atypical depression as a distinct subtype in diagnostic criteria (DSM-IV).