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Atypical depression in an outpatient psychiatric population

1993; Wiley; Volume: 1; Issue: 5 Linguagem: Inglês

10.1002/depr.3050010506

1520-6394

Sidney Zisook, Stephen R. Shuchter, Thomas J. Gallagher, Paul Sledge,

Mental Health Research Topics

Abstract The authors were interested in the frequency and associated symptoms of atypical major depressions and dysthymia in an outpatient psychiatric population. Of 1,000 consecutive admissions to an outpatient psychiatric clinic, 115 were given diagnoses of major depression and another 102 the diagnosis of dysthymia using DSM‐III‐R criteria. On the basis of a modified version of the Columbia criteria for atypical depression and/or complaints of both hyperphagia and hypersomnia, patients were categorized into nontypical and atypical subtypes. In addition, demographic characteristics, past personal and family histories of psychiatric illnesses, and present symptomatology were obtained. Of the 175 patients who were diagnosed with major depression, 62 (36%) met criteria for definite or probable atypical depression using the Columbia criteria and 71 (46%) using the reversed neurovegetative symptom criteria. Of the 102 patients who were diagnosed with dysthymia, 43 (43 %) met criteria for the atypical subtype using the Columbia criteria and 54 (54%) by the reversed symptom criteria. In general, the atypical and nonatypical groups were more similar than different. In particular, the two groups differed little in demographic characteristics or in symptoms that historically have been associated with by steroid, atypical, anxious, or endogenomorphic subtypes of depression. While there was substantial overlap between the two competing definitions of atypical depression, many patients satisfied only one or the other criteria. Atypical major depression and dysthymia are frequently encountered forms of mood disorders seen in outpatient populations, although the prevalence is highly determined by definitions and thresholds. The pattern of symptoms are more alike than dissimilar to those observed in nonatypical mood disturbances. Depression 1:268–274 (1993). © 1993 Wiley‐Liss, Inc.