Atypical depression is thought to respond best to which of the following?
Exam Question Dec 2015
Exam Question Dec 2015
Atypical depression
The current use of the term atypical depression relates to klein and Davis' description in 1969.
Atypical depression consists of low mood with mood reactivity (mood varies greatly in response to specific events) and a reversal of the features normally seen in depression. They have hypersomnia (sleep a lot), hyperphagia (eat a lot), weight gain, and libidinal increases.
People with atypical depression tend to respond best to MAOI's (Parker, 2002). Their response to tricyclics is poor, and SSRI's perform somewhere in the middle.
Atypical depression is not specifically recognised in ICD-10. The DSM-IV defines Atypical Depression as a subtype of Major Depressive Disorder with Atypical Features, characterized by:-
(a) Mood reactivity (i.e., mood brightens in response to actual or potential positive events)
(b) At least two of the following:
- Significant weight gain or increase in appetite;
- Hypersomnia (sleeping too much, as opposed to the insomnia present in melancholic depression);
- Leaden paralysis (i.e., heavy, leaden feelings in arms or legs);
- Long-standing pattern of interpersonal rejection sensitivity (not limited to episodes of mood disturbance) that results in significant social or occupational impairment.
(c) Criteria are not met for Melancholic Depression or Catatonic Depression during the same episode.
Parker G (2002) Atypical Depression: A Reappraisal. American Journal of Psychiatry. 159, 1470-1479
