title: Mixed, melancholic, and anxious features in depression: a cross-sectional study of sociodemographic and clinical correlates.
abstract: BACKGROUND
  Major depression (MD) is currently viewed as a heterogeneous condition, characterized by different psychopathological dimensions.
  
  
  METHODS
  Our sample was composed of 1,289 nonpsychotic bipolar/unipolar depressed patients. Participants were divided into mixed (MXD), melancholic (MEL), and anxious (ANX) depressed, according to a hierarchical functional model. Sociodemographic and clinical variables were compared across depressive subtypes by χ2 test and analysis of variance. The Young Mania Rating Scale (YMRS) and 2 subscales (melancholic [MEL-S] and psychic-somatic anxiety [PSOM-ANX]) from the Hamilton Depression Rating Scale also served as continuous outcome measures.
  
  
  RESULTS
  MXD patients more frequently had bipolar I disorder (BD I), younger age of onset, and a higher familial load for mood disorders. MEL and ANX patients were more frequently diagnosed with major depressive disorder and reported a higher suicide risk. YMRS scores in depression was associated with BD I diagnosis (P < .0001) and manic polarity of the last episode (P < .0001), while a depressive polarity of the last episode (P < .0001) was associated with higher MEL-S score. No specific predictor was associated with PSOM-ANX score.
  
  
  CONCLUSIONS
  Overall, our findings suggest that mixed depressive features are associated with significant hallmarks of bipolarity, and melancholic features may be influenced by previous depressive polarity. The symptom domain of anxiety appears to have no specific predictor.
authors.affiliation: Department of Biomedical and Neuro-Motor Sciences, University of Bologna, Bologna, Italy. E-mail: alessandro.serretti@gmail.com.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Zaninotto
authors.forename: Daniel
authors.initials: D
authors.lastname: Souery
authors.forename: Raffaella
authors.initials: R
authors.lastname: Calati
authors.forename: Paolo
authors.initials: P
authors.lastname: Scudellari
authors.forename: Luigi
authors.initials: L
authors.lastname: Janiri
authors.forename: Stuart
authors.initials: S
authors.lastname: Montgomery
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
authors.forename: Joseph
authors.initials: J
authors.lastname: Zohar
authors.forename: Julien
authors.initials: J
authors.lastname: Mendlewicz
authors.forename: Alessandro
authors.initials: A
authors.lastname: Serretti
mesh_terms: D001007:Anxiety / Q000523:psychology; D001714:Bipolar Disorder / Q000523:psychology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000523:psychology; D003865:Major Depressive Disorder / Q000145:classification / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors