Depression with atypical features in a sample of primary care outpatients: prevalence, specific characteristics and consequences.
BACKGROUND
In the context of the current debate on the clinical relevance of atypical depression, the present study investigated the prevalence and specific characteristics of the disorder in depressed primary care outpatients and compared patients with atypical and with the prototypical form of depression ("non-atypical" depression).


METHODS
403 patients were examined using the Composite International Diagnostic Interview, Inventory of Depressive Symptomatology, Hamilton Depression Scale and DSM-IV criteria. Configurational frequency analyses (CFA) were conducted to identify non-random configurations of symptoms. Moreover, tests for independent sample comparisons were applied.


RESULTS
The prevalence of atypical depression in our sample of depressed patients was 26.3%. CFA revealed one significant symptom pattern: mood reactivity without additional atypical features (p<0.000001). A significant difference emerged between patients suffering from atypical versus non-atypical depression in terms of severity (p< or =0.001).


CONCLUSIONS
The sample size was modest.


CONCLUSIONS
A considerable proportion of depressed primary care outpatients may suffer from atypical depression which may contribute to under-recognition of depression in primary care. Results of CFA indicated the significance of mood reactivity which may also occur in depressed patients without additional atypical symptoms. Patients with atypical depression may suffer from less severe depression as compared to patients with non-atypical depression.
Henkel
Verena
V
Department of Psychiatry, Ludwig-Maximilians-University Munich, Nussbaumstr. 7, D-80336 Munich, Germany. verena.henkel@psy.med.uni-muenchen.de
Mergl
Roland
R
Coyne
James C
JC
Kohnen
Ralf
R
Allgaier
Antje-Kathrin
AK
Rühl
Elke
E
Möller
Hans-Jürgen
HJ
Hegerl
Ulrich
U
D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011594:Psychometrics; D015203:Reproducibility of Results