REVERSED NEUROVEGETATIVE SYMPTOMS OF DEPRESSION - A COMMUNITY STUDY OF ONTARIO

Objective: Most research on depression with reversed neurovegetative f eatures (hypersomnia, hyperphagia, and weight gain) has been based on site-specific clinic-based samples. The goal of this study was to deli neate the epidemiology of reversed symptoms in a large community sampl e and to use other symptom patterns for comparison. Method: Interviewe rs assessed 8,116 subjects across Ontario, aged 15-64 years, by using the World Health Organization Composite International Diagnostic Inter view. Individuals who met the DSM-III-R criteria for major depression, current or lifetime, were classified into four groups on the basis of lifetime neurovegetative symptoms: episodes of typical symptoms only, episodes of reversed symptoms only, neither type, or both types (fluc tuating-symptom group). The groups were compared on demographic charac teristics, comorbidity, disability, and health care utilization. Resul ts: Of the 653 individuals with lifetime major depression, 11.3% had e pisodes of reversed symptoms only, and another 5.8% were classified as fluctuating Most of the differences among the foul. groups were due t o the unique characteristics of the groups with neither type of episod e or a fluctuating pattern; individuals who had experienced only rever sed symptoms were remarkably similar to those who had had only typical symptoms. The fluctuating-symptom group had high rates of comorbidity , substance abuse, and health care utilization. Conclusions: Several p opular beliefs about depression with reversed features did not hold tr ue for this community sample. Identifying individuals who fluctuate be tween reversed and typical episodes may be important in studies of maj or depression, in particular when reversed neurovegetative symptoms ar e a consideration.