LATENT CLASS ANALYSIS OF LIFETIME DEPRESSIVE SYMPTOMS IN THE NATIONALCOMORBIDITY SURVEY

Objective: Although clinical trials have documented the importance of identifying individuals with major depression with atypical features, there are fewer epidemiological data; In a prior report, the authors u sed latent class analysis (LCA) to identify a distinctive atypical dep ressive subtype; they sought to replicate that finding in the current study. Method: Using the National Comorbidity Survey data, the authors applied LCA to 14 DSM-III-R major depressive symptoms in the particip ants' lifetime worst episodes (N = 2,836), Validators of class members hip included depressive disorder characteristics, syndrome consequence s, demography, comorbidity, personality/attitudes, and parental psychi atric history. Results: The best-Silting LCA solution had six classes. Four were combinations of atypicality and severity: severe atypical, mild atypical, severe typical, and mild typical. Syndrome severity (se vere atypical and typical versus mild atypical and typical classes) wa s associated with a pronounced pattern of more and longer episodes, wo rse syndrome consequences, increased psychiatric comorbidity, more dev iant personality and attitudes, and parental alcohol/drug use disorder . Syndrome atypicality (severe and mild atypical versus severe and mil d typical classes) was associated with decreased syndrome consequences , comorbid conduct disorder and social phobia, higher interpersonal de pendency and lower self-esteem, and parental alcohol/drug use disorder . Conclusions: As in prior reports,the atypical subtype of depression can be identified in epidemiological samples and, like typical depress ion, exists in mild and severe variants. Atypical depressive subtypes were characterized by several distinctive features. However, the corre spondence between epidemiologically derived typologies of atypical dep ression and DSM-IV major depression with atypical features is not yet known.