ARE NEUROVEGETATIVE SYMPTOMS STABLE IN RELAPSING OR RECURRENT ATYPICAL DEPRESSIVE EPISODES

Few data exist that assess the presence of reversed and positive neuro vegetative symptoms through successive depressive episodes, To assess the stability of depressive symptoms across episodes, we studied 74 ou tpatients with atypical unipolar major depression, diagnosed by the St ructured Clinical Interview for DSM-III-R, before response to fluoxeti ne treatment and again after relapse on either fluoxetine or placebo, Patients were assessed at baseline with the Atypical Depression Diagno sis Scale and at baseline and during follow-lip with the 17-item Hamil ton Racing Scale for Depression, Thirty-two (43%) of responders had a relapse or recurrence, 21 (66%) of whom had a predominance of reversed of positive neurovegetative symptoms at baseline, Nine of 10 (90%) pa tients with reversed symptoms at baseline had the same symptoms when t hey relapsed; seven of 11 (64%) of those with positive symptoms at bas eline had positive symptoms again (kappa 0.557), Overall, five of 21 ( 24%) had changes in their disturbances in sleep, appetite, or weight w hen they relapsed This study supports the relative stability of neurov egetative symptoms in atypical depression across episodes.