MAJOR DEPRESSIVE SUBTYPES AND TREATMENT RESPONSE

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.