Nervenheilkunde 2009; 28(04): 193-199
DOI: 10.1055/s-0038-1628602
Thema zum Schwerpunkt
Schattauer GmbH

Prevalence, clinical importance and validation of atypical depression

Artikel in mehreren Sprachen: deutsch | English
M. Riedel
1   Abteilung für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München
,
F. Seemüller
1   Abteilung für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München
,
F. Wickelmaier
1   Abteilung für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München
,
R. Schennach-Wolff
1   Abteilung für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München
,
M. Adli
2   Abteilung für Psychiatrie und Psychotherapie, Campus, Charité Mitte, Berlin
,
M. Bauer
3   Abteilung für Psychiatrie und Psychotherapie, Carl Gustav Carus Krankenhaus, Technische Universität Dresden
,
K. Kranmüller
4   Abteilung für Psychiatrie und Psychotherapie, University Heidelberg
,
P. Brieger
5   Abteilung für Psychiatrie und Psychotherapie, Martin-Luther Universität Halle-Wittenberg
,
G. Laux
6   Abteilung für Psychiatrie und Psychotherapie, Inn-Salzach-Klinikum, Wasserburg
,
W. Bender
7   Abteilung für Psychiatrie und Psychotherapie, Isar-Amper-Klinikum, Haar
,
I. Häuser
8   Abteilung für Psychiatrie und Psychotherapie, Campus Charité Benjamin Franklin, Berlin
,
J. Zeiler
9   Abteilung für Psychiatrie und Psychotherapie, Auguste-Viktoria-Krankenhaus, Berlin
,
W. Gaebel
10   Abteilung für Psychiatrie und Psychotherapie, Universität Düsseldorf
,
M. Jäger
1   Abteilung für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München
,
H.-J. Möller
1   Abteilung für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München
,
V. Henkel
1   Abteilung für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München
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Publikationsverlauf

Eingegangen am: 03. Dezember 2008

angenommen am: 20. Januar 2009

Publikationsdatum:
24. Januar 2018 (online)

Summary

Background: The objective was to assess thefrequency of atypical depression (AD) in depressedinpatients; to compare clinical featuresof patients with atypical and nonatypical depression(Non-AD) and to evaluate the meaningof single psychopathological symptomswith special respect to mood reactivity. Method: Diagnoses were assessed accordingto DSM-IV using SCID and AMDP. Diagnosis ofatypical depression was defined according tocriteria of the DSM-IV specifier for AD. All patientswere rated using HAMD-21. Results: Ahigh percentage of patients met criteria forAD. Women were more likely to suffer fromAD. There were no significant differences betweenAD and Non AD patients regarding age,HAMD total baseline score, and diagnosis ofany bipolar illness. In terms of psychopathologypatients with AD were significantly morelikely to suffer from somatic anxiety, somaticsymptoms, guilt, genital symptoms, depersonalisationand suspiciousness as defined byHAMD-21 items. Interestingly, mood reactivitywas not found to be significantly associatedwith the presence of two or more additionalsymptoms of AD. Conclusion: Frequencyof AD may be underestimated, especially in inpatientsamples. Further studies of inpatientsamples are recommended. Quality of distinctanxiety symptoms may be different in bothgroups, with AD patients being more likely tosuffer from somatic symptoms and somaticanxiety.

 
  • Literatur

  • 1 Agresti A. Categorical data analysis. New York: Wiley; 2002
  • 2 Akiskal HS, Benazzi F. Atypical depression: a variant of bipolar II or a bridge between unipolar and bipolar II?. J Affect Disord 2005; 84: 209-217.
  • 3 Angst J. et al. Atypical depressive syndromes in varying definitions. Eur Arch Psychiatry Clin Neurosci 2006; 256: 44-54.
  • 4 Angst J. et al. Toward validation of atypical depression in the community: results of the Zurich cohort study. J Affect Disord 2002; 72: 125-138.
  • 5 APA-American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders – DSMIV-TR. (4th edition). Washington DC: 2000
  • 6 Asnis GM, McGinn LK, Sanderson WC. Atypical depression: clinical aspects and noradrenergic function. Am J Psychiatry 1995; 152: 31-36.
  • 7 Cording C, Gaebel W, Spengler A. Die neue psychiatrische Basisdokumentation. Eine Empfehlung der DGPPN zur Qualitätssicherung im (teil-) stationären Bereich. Spektrum Psychiatrie Nervenheilkunde 1995; 3-41.
  • 8 Derecho CN. et al. Atypical depression among psychiatric inpatients: clinical features and personality traits. J Affect Disord 1996; 39: 55-59.
  • 9 Dorz S. et al. Depression in inpatients: bipolar vs unipolar. Psychol Rep 2003; 92: 1031-1039.
  • 10 Drieling T, Scharer LO, Langosch JM. The Inventory of Depressive Symptomatology: German translation and psychometric validation. Int J Methods Psychiatr Res 2007; 16: 230-236.
  • 11 Henkel V. et al. Treatment of depression with atypical features: a meta-analytic approach. Psychiatry Res 2006; 141: 89-101.
  • 12 Henkel V. et al. Depression with atypical features in a sample of primary care outpatients: prevalence, specific characteristics and consequences. J Affect Disord 2004; 83: 237-242.
  • 13 Horwath E. et al. The validity of major depression with atypical features based on a community study. J Affect Disord 1992; 26: 117-125.
  • 14 Magnusson A, Partonen T. The diagnosis, symptomatology, and epidemiology of seasonal affective disorder. CNS.Spectr 2005; 10: 625-634.
  • 15 Murck H. [Atypical depression and related illnesses--neurobiological principles for their treatment with Hypericum extract]. Wien Med Wochenschr 2002; 152: 398-403.
  • 16 Nierenberg AA. et al. Course and treatment of atypical depression. J Clin Psychiatry 1998; 59 Suppl (Suppl. 18) 5-9.
  • 17 Novick JS. et al. Clinical and demographic features of atypical depression in outpatients with major depressive disorder: preliminary findings from STAR*D. J Clin Psychiatry 2005; 66: 1002-1011.
  • 18 Parker G. et al. Atypical depression: Australian and US studies in accord. Curr Opin Psychiatry 2005; 18: 1-5.
  • 19 Parker G. et al. Atypical depression: a reappraisal. Am J Psychiatry 2002; 159: 1470-1479.
  • 20 Pietzcker A, Gebhardt R. Depressive syndromes and scales in the AMDP-system. Acta.Psychiatr. Scand Suppl 1983; 310 65–84: 65-84.
  • 21 Pietzcker A. et al. The syndrome scales in the AMDPSystem. Mod Probl Pharmacopsychiatry 1983; 20: 88-99.
  • 22 Posternak MA. Biological markers of atypical depression. Harv Rev Psychiatry 2003; 11: 1-7.
  • 23 Posternak MA, Zimmerman M. Partial validation of the atypical features subtype of major depressive disorder. Arch Gen Psychiatry 2002; 59: 70-76.
  • 24 Posternak MA, Zimmerman M. The prevalence of atypical features across mood, anxiety, and personality disorders. Compr Psychiatry 2002; 43: 253-262.
  • 25 Quitkin FM. et al. A reappraisal of atypical depression. Am J Psychiatry 2003; 160: 798-800.
  • 26 Quitkin FM. et al. Further evidence that a placebo response to antidepressants can be identified. Am J Psychiatry 1993; 150: 566-570.
  • 27 Robertso HA. et al. Atypical depressive symptoms and clusters in unipolar and bipolar depression. Acta Psychiatr Scand 1996; 94: 421-427.
  • 28 Roth M. Categorical and unitary classification of neurotic disorder. J R Soc Med 1990; 83: 609-614.
  • 29 Roth M. et al. Studies in the classification of affective disorders. The relationship between anxiety states and depressive illnesses. I. Br J Psychiatry 1972; 121: 147-161.
  • 30 Rush AJ. et al. The Inventory of Depressive Symptomatology (IDS): psychometric properties. Psychol Med 1996; 26: 477-486.
  • 31 Silverstein B, Cohen P, Kasen S. Should additional symptoms be included in criteria for atypical depression?. Psychiatry Res 2006; 144: 87-89.
  • 32 Wittchen HU. et al. Strukturiertes Klinisches Interview für DSM-IV. Göttingen: Hogrefe; 1997