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P01-391 - The Diagnosis of Melancholic and Atypical Depression During Pregnancy

Published online by Cambridge University Press:  17 April 2020

M. Kammerer
Affiliation:
Institute of Reproductive and Developmental Biology, Imperial College London, UK Institute of Psychiatry, King's College London, London, UK Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
V. Glover
Affiliation:
Institute of Reproductive and Developmental Biology, Imperial College London, UK
C. Pinard
Affiliation:
Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
H. Künzli
Affiliation:
Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
A. Taylor
Affiliation:
School of Biomedical and Health Sciences, King's College London, London, UK
B. von Castelberg
Affiliation:
Department of Obstetrics and Gynaecology, Stadtspital Triemli Zurich, Zurich, Switzerland
M. Marks
Affiliation:
Institute of Psychiatry, King's College London, London, UK

Abstract

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Introduction

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.

Method

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.

Results

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.

Conclusions

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.

Type
Diagnostic / Classification / Psychopathology
Copyright
Copyright © European Psychiatric Association 2010
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