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Multicenter Study
. 2012;7(10):e48200.
doi: 10.1371/journal.pone.0048200. Epub 2012 Oct 26.

Clinical patterns and treatment outcome in patients with melancholic, atypical and non-melancholic depressions

Margalida Gili  1 , Miquel Roca, Silvia Armengol, David Asensio, Javier Garcia-Campayo, Gordon Parker
Affiliations
Multicenter Study

Clinical patterns and treatment outcome in patients with melancholic, atypical and non-melancholic depressions

Margalida Gili et al. PLoS One. 2012.

Abstract

Objective: To assess sociodemographic, clinical and treatment factors as well as depression outcome in a large representative clinical sample of psychiatric depressive outpatients and to determine if melancholic and atypical depression can be differentiated from residual non-melancholic depressive conditions.

Subjects/materials and method: A prospective, naturalistic, multicentre, nationwide epidemiological study of 1455 depressive outpatients was undertaken. Severity of depressive symptoms was assessed by the Hamilton Depression Rating Scale (HDRS) and the Self Rated Inventory of Depressive Symptomatology (IDS-SR(30)). IDS-SR(30) defines melancholic and atypical depression according to DSM-IV criteria. Assessments were carried out after 6-8 weeks of antidepressant treatment and after 14-20 weeks of continuation treatment.

Results: Melancholic patients (16.2%) were more severely depressed, had more depressive episodes and shorter episode duration than atypical (24.7%) and non-melancholic patients. Atypical depressive patients showed higher rates of co-morbid anxiety disorders and substance abuse. Melancholic patients showed lower rates of remission.

Conclusion: Our study supports a different clinical pattern and treatment outcome for melancholic and atypical depression subtypes.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

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