title: Clinical patterns and treatment outcome in patients with melancholic, atypical and non-melancholic depressions.
abstract: OBJECTIVE
  To assess sociodemographic, clinical and treatment factors as well as depression outcome in a large representative clinical sample of psychiatric depressive outpatients and to determine if melancholic and atypical depression can be differentiated from residual non-melancholic depressive conditions.
  A prospective, naturalistic, multicentre, nationwide epidemiological study of 1455 depressive outpatients was undertaken. Severity of depressive symptoms was assessed by the Hamilton Depression Rating Scale (HDRS) and the Self Rated Inventory of Depressive Symptomatology (IDS-SR(30)). IDS-SR(30) defines melancholic and atypical depression according to DSM-IV criteria. Assessments were carried out after 6-8 weeks of antidepressant treatment and after 14-20 weeks of continuation treatment.
  
  
  RESULTS
  Melancholic patients (16.2%) were more severely depressed, had more depressive episodes and shorter episode duration than atypical (24.7%) and non-melancholic patients. Atypical depressive patients showed higher rates of co-morbid anxiety disorders and substance abuse. Melancholic patients showed lower rates of remission.
  
  
  CONCLUSIONS
  Our study supports a different clinical pattern and treatment outcome for melancholic and atypical depression subtypes.
authors.affiliation: Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain. mgili@uib.es
authors.forename: Margalida
authors.initials: M
authors.lastname: Gili
authors.forename: Miquel
authors.initials: M
authors.lastname: Roca
authors.forename: Silvia
authors.initials: S
authors.lastname: Armengol
authors.forename: David
authors.initials: D
authors.lastname: Asensio
authors.forename: Javier
authors.initials: J
authors.lastname: Garcia-Campayo
authors.forename: Gordon
authors.initials: G
authors.lastname: Parker
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D003863:Depression / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology*; D003866:Depressive Disorder / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000928:Antidepressive Agents