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Characteristics, comorbidities, and correlates of atypical depression: evidence from the UK Biobank Mental Health Survey

Published online by Cambridge University Press:  02 May 2019

Anamaria Brailean Open the ORCID record for Anamaria Brailean [Opens in a new window] ,
Jessica Curtis ,
Katrina Davis ,
Alexandru Dregan  and
Matthew Hotopf
Anamaria Brailean*
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
Jessica Curtis
Affiliation:
Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
Katrina Davis
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom South London and Maudsley NHS Foundation Trust, London, United Kingdom
Alexandru Dregan
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
Matthew Hotopf
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom South London and Maudsley NHS Foundation Trust, London, United Kingdom
*
Author for correspondence: Anamaria Brailean, E-mail: [email protected]
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Abstract

Background

Depression is a heterogeneous disorder with multiple aetiological pathways and multiple therapeutic targets. This study aims to determine whether atypical depression (AD) characterized by reversed neurovegetative symptoms is associated with a more pernicious course and a different sociodemographic, lifestyle, and comorbidity profile than nonatypical depression (nonAD).

Methods

Among 157 366 adults who completed the UK Biobank Mental Health Questionnaire (MHQ), N = 37 434 (24%) met the DSM-5 criteria for probable lifetime major depressive disorder (MDD) based on the Composite International Diagnostic Interview Short Form. Participants reporting both hypersomnia and weight gain were classified as AD cases (N = 2305), and the others as nonAD cases (N = 35 129). Logistic regression analyses were conducted to examine differences between AD and nonAD in depression features, sociodemographic and lifestyle factors, lifetime adversities, psychiatric and physical comorbidities.

Results

Persons with AD experienced an earlier age of depression onset, longer, more severe and recurrent episodes, and higher help-seeking rates than nonAD persons. AD was associated with female gender, unhealthy behaviours (smoking, social isolation, low physical activity), more lifetime deprivation and adversity, higher rates of comorbid psychiatric disorders, obesity, cardiovascular disease (CVD), and metabolic syndrome. Sensitivity analyses comparing AD persons with those having typical neurovegetative symptoms (hyposomnia and weight loss) revealed similar results.

Conclusions

These findings highlight the clinical and public health significance of AD as a chronic form of depression, associated with high comorbidity and lifetime adversity. Our findings have implications for predicting depression course and comorbidities, guiding research on aetiological mechanisms, planning service use and informing therapeutic approaches.

Keywords

Adverse life eventsatypical depressioncardiovascular diseasedepression coursemetabolic syndromeobesitypsychiatric comorbiditiessocioeconomic disadvantageunhealthy lifestyle
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 7 , May 2020 , pp. 1129 - 1138
Copyright
Copyright © Cambridge University Press 2019

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