Abstract
Atypical and melancholic subtypes of depression based on the Diagnostic and Statistical Manual (DSM) IV are important concepts,
especially for biological psychiatry. The aim of this study was to determine whether the symptoms used for the diagnoses of
atypical and melancholic depression can distinguish these subtypes during pregnancy. A modified version of the Structured
Clinical Interview for DSM IV (SCID interview) was used that allowed assessment of all DSM IV symptoms of melancholic and
atypical depression with depressed and non-depressed women in pregnancy. A Swiss cohort of 449 women was interviewed. Four
diagnostic groups were compared: women with melancholic, atypical or non specified depression, and those without depression.
Seventeen per cent of the cohort met SCID criteria for a depressive episode of depression at least once in pregnancy, with
melancholic depression 2.4%, atypical depression 4.4% and non specified depression 10.2%. Many of the symptoms used to distinguish
atypical and melancholic depression did not discriminate between these groups during pregnancy. However some, such as mood
reactivity, distinct quality of mood and sleep pattern, did discriminate. Differential diagnosis between melancholic and atypical
depression in pregnancy needs to be based on pregnancy specific definitions. The possible therapeutic consequences and the
neurobiological basis for these findings warrant further research.
especially for biological psychiatry. The aim of this study was to determine whether the symptoms used for the diagnoses of
atypical and melancholic depression can distinguish these subtypes during pregnancy. A modified version of the Structured
Clinical Interview for DSM IV (SCID interview) was used that allowed assessment of all DSM IV symptoms of melancholic and
atypical depression with depressed and non-depressed women in pregnancy. A Swiss cohort of 449 women was interviewed. Four
diagnostic groups were compared: women with melancholic, atypical or non specified depression, and those without depression.
Seventeen per cent of the cohort met SCID criteria for a depressive episode of depression at least once in pregnancy, with
melancholic depression 2.4%, atypical depression 4.4% and non specified depression 10.2%. Many of the symptoms used to distinguish
atypical and melancholic depression did not discriminate between these groups during pregnancy. However some, such as mood
reactivity, distinct quality of mood and sleep pattern, did discriminate. Differential diagnosis between melancholic and atypical
depression in pregnancy needs to be based on pregnancy specific definitions. The possible therapeutic consequences and the
neurobiological basis for these findings warrant further research.
- Content Type Journal Article
- DOI 10.1007/s00737-010-0187-x
- Authors
- Martin Kammerer, Imperial College London, Institute of Reproductive and Developmental Biology, Du Cane Road, London, W12 ONN UK
- Vivette Glover, Imperial College London, Institute of Reproductive and Developmental Biology, Du Cane Road, London, W12 ONN UK
- Claudia Pinard Anderman, Department of Applied Psychology, Zurich University of Applied Sciences, Minervastr. 30, CH 8032 Zurich, Switzerland
- Hansjörg Künzli, Department of Applied Psychology, Zurich University of Applied Sciences, Minervastr. 30, CH 8032 Zurich, Switzerland
- Alyx Taylor, Imperial College London, Institute of Reproductive and Developmental Biology, Du Cane Road, London, W12 ONN UK
- Brida von Castelberg, Department of Obstetrics and Gynaecology, Stadtspital Triemli Zurich, Birmensdorferstr. 501, CH 8063 Zurich, Switzerland
- Maureen Marks, Institute of Psychiatry, King’s College London, De Crespigny Park, London, SE5 8AF UK
- Journal Archives of Women’s Mental Health
- Online ISSN 1435-1102
- Print ISSN 1434-1816