ATYPICAL DEPRESSION AMONG PSYCHIATRIC-INPATIENTS - CLINICAL-FEATURES AND PERSONALITY-TRAITS

Objective: This study investigates the frequency and characteristics o f Atypical Depression (AD) among depressed inpatients. Method: Twenty- one depressed inpatients received DSM-IV diagnoses, were rated on the Hamilton Depression Rating Scale (HAMD), and assessed for AD using the Atypical Depressive Disorder Scale. AD was defined as the presence of mood reactivity and two of four associated features: hyperphagia, hyp ersomnia, leaden paralysis, rejection sensitivity. Mood reactivity was defined as the ability to reach 50% of a non-depressed mood. All subj ects completed the SCL-90, MCMI-II, and a suicide survey. Results: Sev en patients (33%) met criteria for AD. AD and non-AD patients did not differ in. terms of severity of depression, history of suicide attempt s, levels of clinical symptomatology, age of onset of depression, prio r hospitalizations, and most personality characteristics. However, AD patients scored significantly higher than non-AD patients on the SCL-9 0 Interpersonal Sensitivity and MCMI-II Avoidant scales, and were mere ly likely to be single. Conclusion: AD is fairly prevalent on an inpat ient service, comparable to the frequency found in outpatient settings . AD is not a milder form of depression. The only differences between AD and non-AD patients reflect the personality trait of rejection sens itivity which is a defining feature of AD.