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Testing DSM-IV Definition of Atypical Depression

  • Published:
Annals of Clinical Psychiatry

Abstract

The definition of atypical depression (AD) has recently seen a rebirth of studies, as the evidence supporting DSM-IV atypical features criteria is weak. Study aim was to test the validity of DSM-IV definition of AD. Consecutive 202 major depressive disorder (MDD) and 281 bipolar II outpatients were interviewed, during a major depressive episode (MDE), with the Structured Clinical Interview for DSM-IV. The relationships of DSM-IV AD versus variables often reported to distinguish AD and non-AD (gender, age, onset, bipolar II, axis I comorbidity, MDE severity, residual MDE symptoms, depressive mixed state), and versus bipolar family history, were tested. Each DSM-IV AD symptom's relationship with the variables found significantly associated to DSM-IV AD was then tested, in order to assess the degree of concordance among all AD symptoms. Associations were tested by univariate logistic regression (STATA 7). Frequency of DSM-IV AD was 42.8%. DSM-IV AD was significantly more common in bipolar II versus MDD (53.7% vs. 27.7%, p = 0.0000). DSM-IV AD significant associations were the following: bipolar II, female gender, lower age, lower age of onset, residual MDE symptoms, axis I comorbidity, psychotic features, depressive mixed state, and bipolar family history. Testing associations of each DSM-IV AD symptom versus the variables found associated to DSM-IV AD showed high concordance. All AD symptoms were significantly associated with DSM-IV AD, and with most study variables. Results support the current DSM-IV definition of AD.

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Authors and Affiliations

  1. Outpatient Psychiatry Center, University of California at San Diego (, USA

    Franco Benazzi

  2. Collaborating Center in Ravenna and Forli, Italy

    Franco Benazzi

  3. Department of Psychology, University of Bologna, Bologna, Italy

    Franco Benazzi

  4. Department of Psychiatry, National Health Service, Forli, Italy

    Franco Benazzi

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Benazzi, F. Testing DSM-IV Definition of Atypical Depression. Ann Clin Psychiatry 15, 9–16 (2003). https://doi.org/10.1023/A:1023272408562

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