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Epidemiology of Major Depression With Atypical Features: Results From the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)
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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 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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“…the observation that women are more likely to experience disturbances of sleep, appetite and energy during a depression (Silverstein, 1999), as well as more likely to experience ‘‘atypical’’ depression, with hypersomnia and weight gain (Young et al., 1990; Angst et al., 2002; Blanco et al., 2012).”
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“Atypical depression may be more common in bipolar depression (Akiskal and Benazzi, 2005; Baldessarini et al., 2010; Blanco et al., 2012; Mitchell et al., 2008).”
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Self-citation
Metadata
- 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.
- 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)
- 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
- green
- europepmc.org
- 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 (medical) › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › 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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