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Atypical depression information


Atypical depression
Other namesDepression with atypical features
Depression subtypes
SpecialtyPsychiatry
SymptomsLow mood, mood reactivity, hyperphagia, hypersomnia, leaden paralysis, interpersonal rejection sensitivity
Complicationsrisk of self harm
Usual onsetTypically adolescence[1]
TypesPrimary anxious, primarily vegetative[1]
Risk factorsBipolar disorder, anxiety disorder, female sex[2]
Differential diagnosisMelancholic depression, anxiety disorder, bipolar disorder
Frequency15-29% of depressed patients[3]

Atypical depression is defined in the DSM-IV as depression that shares many of the typical symptoms of major depressive disorder or dysthymia but is characterized by improved mood in response to positive events. In contrast to those with atypical depression, people with melancholic depression generally do not experience an improved mood in response to normally pleasurable events. Atypical depression also often features significant weight gain or an increased appetite, hypersomnia, a heavy sensation in the limbs, and interpersonal rejection sensitivity that results in significant social or occupational impairment.[4]

Despite its name, "atypical" depression does not mean it is uncommon or unusual.[5] The reason for its name is twofold: it was identified with its "unique" symptoms subsequent to the identification of melancholic depression and its responses to the two different classes of antidepressants that were available at the time were different from melancholic depression (i.e., MAOIs had clinically significant benefits for atypical depression, while tricyclics did not).[6]

Atypical depression is four times more common in females than in males.[7] Individuals with features of atypical depression tend to report an earlier age of onset (e.g. while in high school) of their depressive episodes. These episodes tend to be more chronic than those of major depressive disorder[2] and only have partial remission between episodes. Younger individuals may be more likely to have atypical features, whereas older individuals may more often have episodes with melancholic features.[4] Atypical depression has high comorbidity with anxiety disorders, carries more risk of suicidal behavior, and has distinct personality psychopathology and biological traits.[2] Atypical depression is more common in individuals with bipolar I,[2] bipolar II,[2][8] cyclothymia[2] or seasonal affective disorder.[4] Depressive episodes in bipolar disorder tend to have atypical features,[2] as does depression with seasonal patterns.[9]

  1. ^ a b Davidson JR, Miller RD, Turnbull CD, Sullivan JL (May 1982). "Atypical depression". Archives of General Psychiatry. 39 (5): 527–534. doi:10.1001/archpsyc.1982.04290050015005. PMID 7092486.
  2. ^ a b c d e f g Singh T, Williams K (April 2006). "Atypical depression". Psychiatry. 3 (4): 33–39. PMC 2990566. PMID 21103169.
  3. ^ Thase ME (2007). "Recognition and diagnosis of atypical depression". The Journal of Clinical Psychiatry. 68 (Suppl 8): 11–16. PMID 17640153.
  4. ^ a b c American Psychiatric Association. (2000). Mood Disorders. In Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) Washington, DC: Author.[page needed]
  5. ^ "Atypical depression". Mayo Clinic. Retrieved 2013-06-23.
  6. ^ Cristancho M (2012-11-20). "Atypical Depression in the 21st Century: Diagnostic and Treatment Issues". Psychiatric Times. Psychiatric Times Vol 28 No 1. 28 (1). Archived from the original on 2013-12-02. Retrieved 23 November 2013.
  7. ^ Łojko D, Rybakowski JK (2017). "Atypical depression: current perspectives". Neuropsychiatric Disease and Treatment. 13: 2447–2456. doi:10.2147/NDT.S147317. PMC 5614762. PMID 29033570.
  8. ^ Perugi G, Akiskal HS, Lattanzi L, Cecconi D, Mastrocinque C, Patronelli A, et al. (1998). "The high prevalence of "soft" bipolar (II) features in atypical depression". Comprehensive Psychiatry. 39 (2): 63–71. doi:10.1016/S0010-440X(98)90080-3. PMID 9515190.
  9. ^ Juruena MF, Cleare AJ (May 2007). "[Overlap between atypical depression, seasonal affective disorder and chronic fatigue syndrome]" [Overlap between atypical depression, seasonal affective disorder and chronic fatigue syndrome]. Revista Brasileira de Psiquiatria (in Portuguese). 29 (Suppl 1): S19–S26. doi:10.1590/S1516-44462007000500005. PMID 17546343.

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