Partial validation of the atypical features subtype of major depressive disorder.

Abstract

ATYPICAL depression stands alone among the DSM-IV¹ mood disorder subtypes as being born out of the modern psychopharmacologic revolution. West and Dally² first used the qualifier atypical to characterize a cohort of depressed patients who appeared phobic, "overreactive," and "hysterical" and exhibited prominent fatigue, reversed diurnal variation, initial insomnia, and an absence of decreased appetite. Sargant³ added that such patients also tended to complain of severe lethargy, hypersomnia, and irritability. Both sets of investigators believed that these patients had good premorbid personalities but were now experiencing a chronic form of depression. They also noted that such patients responded particularly well to monoamine oxidase inhibitors (MAOIs) and less well to tricyclic antidepressants and electroconvulsive therapy.