Clinical and demographic features of atypical depression in outpatients with major depressive disorder: preliminary findings from STAR*D.
OBJECTIVE
To determine the frequency and demographic and clinical characteristics of depression with atypical features in a broadly representative sample of outpatients.


METHODS
Data derived from the first 1500 patients with DSM-IV major depressive disorder enrolled in the Sequenced Treatment Alternatives to Relieve Depression trial at 41 primary care and nonresearch psychiatric outpatient clinics. An algorithm based on the 30-item Inventory of Depressive Symptomatology-Clinician Rating (IDS-C30) determined presence or absence of depression with atypical features. Odds ratios determined whether a variety of demographic and clinical parameters differed between patients meeting and not meeting atypical criteria.


RESULTS
Over 18% of the sample met criteria for atypical features based on items from the IDS-C30. The atypical group was more likely to be female and have an earlier age at onset, greater comorbidity with anxiety symptoms, and greater symptom severity compared with the nonatypical group.


CONCLUSIONS
Previously identified features of atypical depression were confirmed in this large and broadly representative, nonresearch clinical population.
Novick
Jon S
JS
Zucker Hillside Hospital, Glen Oaks, NY, USA.
Stewart
Jonathan W
JW
Wisniewski
Stephen R
SR
Cook
Ian A
IA
Manev
Radmila
R
Nierenberg
Andrew A
AA
Rosenbaum
Jerrold F
JF
Shores-Wilson
Kathy
K
Balasubramani
G K
GK
Biggs
Melanie M
MM
Zisook
Sid
S
Rush
A John
AJ
D000328:Adult; D000553:Ambulatory Care; D015283:Citalopram; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000145:classification / Q000175:diagnosis* / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010555:Personality Inventory / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors