MIDAS Project Publication Abstracts
Posternak, M.A., Zimmerman, M. Partial validation of the atypical
depression subtype. Archives of General Psychiatry, in press.
Background: The atypical features subtype, whose symptoms
include mood reactivity, hypersomnia, hyperphagia, leaden paralysis, and
rejection sensitivity was introduced into the mood disorders section of
DSM-IV following a series of antidepressant trials showing that such
patients responded preferentially to MAO inhibitors. Studies aimed at
validating the atypical features subtype have yielded inconsistent
results. The present study sought to reevaluate the validity of atypical
depression by examining the demographic and clinical features of a large
cohort of depressed patients who met DSM-IV criteria for atypical
features.
Method: Five-hundred and seventy nine psychiatric outpatients with
a current major depressive disorder diagnosis were evaluated for the
presence of atypical features. Detailed demographic and clinical
information was obtained for each patient through semi-structured
interviews. Based on the available literature, we made a series of a
priori hypotheses regarding how depressed patients with atypical
features (n=130) would differ from those without atypical features
(n=449). In addition, we tested the strength of associations between each
of the five atypical symptoms. Results: While many of the predicted
hypotheses were borne out, an equal number were not. Correlation analyses
revealed modest associations between several of the atypical symptoms,
though mood reactivity was not found to be associated with any of the
other atypical symptoms. Conclusion: Our results provide partial
support for the validity of the atypical features subtype of major
depressive disorder.
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