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Characteristics and symptomatology of major depressive disorder with atypical features from symptom to syndromal level.

Authors :
Shi, Yifan
Peng, Daihui
Zhang, Chen
Mellor, David
Wang, Huaning
Fang, Yiru
Wu, Zhiguo
Source :
Journal of Affective Disorders. Jul2023, Vol. 333, p249-256. 8p.
Publication Year :
2023

Abstract

To explore clinical characteristics and symptomatology of major depressive disorder (MDD) with atypical features based on DSM criteria or only reversed vegetative symptoms. A total of 3187 patients who met DSM-IV TR criteria for MDD were enrolled. Demographics and symptomatology covering multiple symptom domains were assessed and compared between three groups of cases: those who met DSM criteria for atypical specifier (the DAD group), those who had at least one reversed vegetative symptoms (hypersomnia or hyperphagia) (the SAD group) without meeting DSM atypical specifier criteria, and those without any reversed vegetative symptoms (the NAD group). The DAD and SAD group accounted for 4.4% and 14.4% of the participants, respectively. The DAD cases were characterized by a highest proportion of hospitalizations, longest duration of current episode and worst quality of life. The DAD and SAD cases were more likely to adopt unhealthy behaviors (smoking and alcohol drinking). Most depressive symptoms related to higher illness severity and treatment resistance were more frequent in the DAD cases, followed by the SAD cases, and least frequent in the NAD cases. A cross-sectional design and a non-validated questionnaire were used. The findings support the role of DSM defined atypical depression as a valid MDD subtype and provide evidence for clinical utility of the simplified approach of defining atypical features based on only reversed vegetative symptoms. This has implications for illness screening, public health, suicide prevention and better treatment planning for depressed individuals with atypical features even below syndromal level. • Over 60% of participants with MDD endorsed at least one atypical symptom. • The DSM defined AD showed the most complex clinical presentation. • The simplified approach defined AD showed more complex clinical picture than MDD without any reversed vegetative symptoms. • The findings highlight the necessary for assessing atypical features even below syndromal level in patients with MDD. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
01650327
Volume :
333
Database :
Academic Search Index
Journal :
Journal of Affective Disorders
Publication Type :
Academic Journal
Accession number :
163695737
Full Text :
https://doi.org/10.1016/j.jad.2023.04.062