Atypical depression, atypical temperament and a differential antidepressant response to fluoxetine and nortriptyline.
We examined the personality characteristics of depressed patients with and without atypical depression. Of 195 depressed outpatients in a randomized treatment trial of fluoxetine or nortriptyline, 16 met DSM-IV criteria for atypical depression. We compared the personality traits and disorders in those with and without atypical depression. In atypical depression, fluoxetine was superior to nortriptyline. On the Temperament and Character Inventory, those with atypical depression had high attachment, low persistence, and high anticipatory anxiety. A temperament construct of these dimensions was associated with a differential antidepressant response, regardless of other atypical features. A temperament derived measure of "rejection sensitivity" defines a group of depressed patients with a differential antidepressant response, regardless of reversed vegetative symptoms.
Joyce
Peter R
PR
Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand. peter.joyce@chmeds.ac.nz
Mulder
Roger T
RT
McKenzie
Janice M
JM
Luty
Suzanne E
SE
Cloninger
C Robert
CR
D000328:Adult; D000367:Age Factors; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009661:Nortriptyline / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D013694:Temperament / Q000187:drug effects*; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D005473:Fluoxetine; D009661:Nortriptyline