The purpose of this study was to investigate the relationships between
depressive subtypes and response to fluoxetine treatment in a large c
ohort of outpatients. We studied 294 outpatients with major depressive
disorder who were then treated with fluoxetine 20 mg/day for 8 weeks,
Treatment outcome was evaluated with the Hamilton Depression Raring S
cale (HDRS)-17, the Clinical Global Impressions-Severity, and with the
HDRS-8; the latter is proposed to be a relatively more specific measu
re of depression severity than the HDRS-17, We assessed the relationsh
ips between degree of treatment response and several depressive subtyp
es (melancholic, atypical, hostile, and anxious depression, double dep
ression, and depression with comorbid personality disorders), after ad
justing for baseline depression severity. We found that nonanxious dep
ressives (patients without any comorbid anxiety disorder) improved sli
ghtly but significantly more during treatment than anxious depressives
on all outcome measures. Melancholic depression was associated with s
lightly less improvement on the HDRS-17 only, whereas the other subtyp
es of depression were not associated with differences in treatment out
come. (C) 1997 Society of Biological Psychiatry.