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Atypical depressive syndromes in varying definitions

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Abstract

Background

Atypical depression (AD) exhibits distinct patterns of gender,bipolar–II disorder, genetic, and neuro–biological measures. Using prospective data from a community sample, this paper identifies criteria (and correlates) for an AD syndrome that maximizes the association with female sex and bipolar–II.

Methods

The Zurich cohort study is composed of 591 subjects selected from a population–based cohort of young adults in the canton of Zurich in Switzerland, screened in 1978 and followed with six interviews through 1999. Seven definitions of atypical depression were tested, using varying combinations of vegetative symptoms and mood reactivity.

Results

The atypical definitions using 2 of 3 (fatigue, overeating, oversleeping) or 2 of 2 (overeating, oversleeping) vegetative symptoms showed the strongest association with gender, bipolarity, and family history of mania. The 2/3 definition was chosen for further analysis due to its high sensitivity for identifying these characteristics. This syndrome had cumulated weighted prevalence of 16.4% (males 9.7%, females 23%); when associated with major depressive episodes, 8.2% (males 3.2%, females 15.1%). AD patients were characterized by high treatment rates, severity, and work impairment, early age of onset and long illness. AD was comorbid with social phobia, binge eating, neurasthenia, migraine headache, and subjective cognitive impairment.

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Author information

Authors and Affiliations

  1. Zurich University Psychiatric Hospital, Lenggstrasse 31, 1931, 8032, Zurich, Switzerland

    J. Angst, A. Gamma, V. Ajdacic–Gross, D. Eich & W. Rössler

  2. E. Hecker Outpatient Psychiatry Centre, Ravenna, Italy

    F. Benazzi

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

    F. Benazzi

  4. Department of Psychology, City College, City University of New York, New York, USA

    B. Silverstein

Authors
  1. J. Angst
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  2. A. Gamma
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  3. F. Benazzi
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  4. B. Silverstein
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  5. V. Ajdacic–Gross
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  6. D. Eich
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  7. W. Rössler
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Correspondence to J. Angst.

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Angst, J., Gamma, A., Benazzi, F. et al. Atypical depressive syndromes in varying definitions. Eur Arch Psychiatry Clin Neurosci 256, 44–54 (2006). https://doi.org/10.1007/s00406-005-0600-z

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  • DOI: https://doi.org/10.1007/s00406-005-0600-z

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