Atypical depression among psychiatric inpatients: clinical features and personality traits.
OBJECTIVE
This study investigates the frequency and characteristics of Atypical Depression (AD) among depressed inpatients.


METHODS
Twenty-one depressed inpatients received DSM-IV diagnoses, were rated on the Hamilton Depression Rating Scale (HAMD), and assessed for AD using the Atypical Depressive Disorder Scale. AD was defined as the presence of mood reactivity and two of four associated features: hyperphagia, hypersomnia, leaden paralysis, rejection sensitivity. Mood reactivity was defined as the ability to reach 50% of a non-depressed mood. All subjects completed the SCL-90, MCMI-II, and a suicide survey.


RESULTS
Seven patients (33%) met criteria for AD. AD and non-AD patients did not differ in terms of severity of depression, history of suicide attempts, levels of clinical symptomatology, age of onset of depression, prior hospitalizations, and most personality characteristics. However, AD patients scored significantly higher than non-AD patients on the SCL-90 Interpersonal Sensitivity and MCMI-II Avoidant scales, and were more likely to be single.


CONCLUSIONS
AD is fairly prevalent on an inpatient service, comparable to the frequency found in outpatient settings. AD is not a milder form of depression. The only differences between AD and non-AD patients reflect the personality trait of rejection sensitivity which is a defining feature of AD.
Derecho
C N
CN
Department of Psychiatry, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467, USA.
Wetzler
S
S
McGinn
L K
LK
Sanderson
W C
WC
Asnis
G M
GM
D000293:Adolescent; D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010359:Patient Readmission; D010554:Personality Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics