Atypical Depression: A Valid Subtype?




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The concept of atypical depression emerged in the 1950s to describe individuals who experienced unusual characteristics of depression and responded better to treatment with monoamine oxidase inhibitors than with tricyclic antidepressants. Over the next 50 years, research refined the criteria for atypical depression, which led to the establishment of the criteria outlined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. These criteria, however, appear to be in need of revision. Newer research downplays the role of mood reactivity and instead emphasizes rejection sensitivity. Atypical depression appears to be a multiaxial condition that ranges across Axis I symptom states to Axis II personality styles, is a nonmelancholic spectrum disorder, and is associated with self-consolatory strategies that are homeostatic and symptomatic.

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J Clin Psychiatry 2007;68(3):e08