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Cited by 127Treatment of Major DepressionMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Epidemiology of Major Depression With Atypical Features: Results From the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

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Blanco, Carlos, Vesga-López, Oriana, Stewart, Jonathan W., Liu, Shang-Min, Grant, Bridget F., Hasin, Deborah S.·2012·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.10m06227PMC PMC3475327
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Abstract

Article AbstractObjective: To examine prevalence, correlates, comorbidity and treatment-seeking among individuals with a lifetime major depressive episode (MDE) with and without atypical features. Method: Data were derived from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions, a large cross-sectional survey of a representative sample (N = 43,093) of the US population that assessed psychiatric disorders using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version (AUDADIS-IV). Comparison groups were defined based on the presence or absence of hypersomnia or hyperphagia in individuals who met criteria for lifetime DSM-IV MDE. Results: The presence of atypical features during an MDE was associated with greater rates of lifetime psychiatric comorbidity, including alcohol abuse, drug dependence, dysthymia, social anxiety disorder, specific phobia, and any personality disorder (all P values < .05), except antisocial personality disorder, than MDE without atypical features. Compared with the latter group, MDE with atypical features was associated with female gender, younger age at onset, more MDEs, greater episode severity and disability, higher rates of family history of depression, bipolar I disorder, suicide attempts, and larger mental health treatment-seeking rates (all P values < .05). Conclusions: Our data provide further evidence for the clinical significance and validity of this depressive specifier. Based on the presence of any of the 2 reversed vegetative symptoms during an MDE, most of the commonly cited validators of atypical depression were confirmed in our study. Major depressive episode with atypical features may be more common, severe, and impairing than previously documented. J Clin Psychiatry © Copyright 2011 Physicians Postgraduate Press, Inc. Submitted: May 6, 2010; accepted October 20, 2010. Online ahead of print: September 6, 2011 (doi:10.4088/JCP.10m06227). Corresponding author: Bridget F. Grant, PhD, PhD, Laboratory of Epidemiology and Biometry, Room 3077, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, MS 9304, 5635 Fishers Lane, Bethesda, MD 20892-9304 (bgrant@willco.niaaa.nih.gov).

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  • Atypical depression is particularly frequent in bipolar disorder and presents with fatigue, hypersomnia and/or hyperphagia.

    “Atypical depression is particularly frequent in BD, and presents with fatigue, hypersomnia and/or hyperphagia (Blanco et al. 2012;Lee et al. 2009;Benazzi ,2006).”

    From The HPA axis in bipolar disorder: Systematic review and meta-analysis (2016) · cites this paper as Blanco et al. 2012

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  1. [9]McGrath PJ Stewart JW Harrison WM Predictive value of symptoms of atypical depression for differential drug treatment outcome J Clin Psychopharmacol 6 1992 12 3 197 202 1629387
  2. [11]Pollit J Young J Anxiety state or masked depression? a study based on the action of monoamine oxidase inhibitors British Journal of Psychiatry 1971 119 143 149 5565901
  3. [16]Quitkin FM Depression With Atypical Features: Diagnostic Validity, Prevalence, and Treatment Prim Care Companion J Clin Psychiatry 6 2002 4 3 94 99 15014736 PMC181236
  4. [19]Quitkin FM Stewart JW McGrath PJ Columbia atypical depression. A subgroup of depressives with better response to MAOI than to tricyclic antidepressants or placebo Br J Psychiatry Suppl 9 1993 21 30 34 8217065
  5. [23]Stewart JW McGrath PJ Quitkin FM Relevance of DMS-III depressive subtype and chronicity of antidepressant efficacy in atypical depression. Differential response to phenelzine, imipramine, and placebo Arch Gen Psychiatry 12 1989 46 12 1080 1087 2686575
  6. [31]Matza LS Revicki DA Davidson JR Stewart JW Depression with atypical features in the National Comorbidity Survey: classification, description, and consequences Arch Gen Psychiatry 8 2003 60 8 817 826 12912765
  7. [37]Grant BF Stinson FS Hasin DS Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions J Clin Psychiatry 10 2005 66 10 1205 1215 16259532
  8. [38]Hasin DS Goodwin RD Stinson FS Grant BF Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions Arch Gen Psychiatry 10 2005 62 10 1097 1106 16203955
  9. [42]Grant BF Stinson FS Hasin DS Dawson DA Chou SP Anderson K Immigration and lifetime prevalence of DSM-IV psychiatric disorders among Mexican Americans and non-Hispanic whites in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions Arch Gen Psychiatry 12 2004 61 12 1226 1233 15583114

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Authors
Blanco, C., Vesga-López, O., Stewart, J. W., Liu, S.-M., Grant, B. F., & Hasin, D. S.
Affiliations
  • New York State Psychiatric Institute (US)
  • Harvard University (US)
  • National Institutes of Health (US)
Corresponding author
Grant, Bridget F.
ORCID
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2011-09-16
Volume
73
Issue
02
Pages
224-232
ISSN
0160-6689 (ISSN-L)
DOI
10.4088/jcp.10m06227
PMC
PMC3475327
OpenAlex
W2076394940
Cited by
127
References
43
Citations by year
2026: 5 · 2025: 7 · 2024: 6 · 2023: 4 · 2022: 10 · 2021: 7 · 2020: 14 · 2019: 10 · 2018: 11 · 2017: 11 · 2016: 8 · 2015: 12 · 2014: 11 · 2013: 5 · 2012: 6
FWCI
5.15
Type
journal article
Language
en
Open access
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • American Foundation for Suicide Prevention
  • National Institutes of Health
  • National Institute on Alcohol Abuse and Alcoholism (R01AA008159, R01-AA08159, K05 AA00161, K05AA014223)
  • National Institute of Mental Health (R01MH082773, MH076051, R01MH076051, MH082773)
  • National Institute on Drug Abuse (R01DA020783, DA019606, R01DA023973, DA020783, DA023200, R01DA019606, DA023973, K02DA023200)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
atypical depression, major depressive episode, hypersomnia, hyperphagia, psychiatric comorbidity, alcohol abuse, drug addiction, bipolar I disorder, suicide attempts, family history of depression, treatment seeking, prevalence, episode severity, disability
MeSH terms
Adolescent, Adult, Aged, Mental Disorders, Depressive Disorder, Major, Major Depressive Disorder, Female, Health Surveys, Humans, Hyperphagia, Disorders of Excessive Somnolence, Male, Middle Aged, Psychiatric Status Rating Scales, Risk Factors, United States, Prevalence

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