Adolescents with atypical depression have more severe depressive and anxiety symptoms and experience more suicidal ideation compared with youth with non-atypical depression, according to a study published this week in the Journal of the American Academy of Child & Adolescent Psychiatry.
Atypical depression is characterized by symptoms such as increased appetite, hypersomnia (daytime sleepiness despite adequate nighttime sleep), and heightened sensitivity to interpersonal rejection. “Despite its significance, the majority of research on atypical depression has focused on adults,” with only a few studies examining this depression subtype in youth, wrote Emine R. Ayvaci, M.D., of the University of Texas Southwestern Medical Center, and colleagues.
The researchers examined the prevalence and clinical characteristics of atypical depression among 1,445 youth (average age of 16, 72.8% female) registered in the Texas Youth Depression and Suicide Research Network. At baseline and follow-up visits at two, four, and six months, the researchers assessed measures such as the participants’ depression and anxiety severity, suicidal propensity, history of traumatic events, school-related functioning, and body mass index (BMI).
Twenty-two percent of the youth had atypical depression (defined as a score of six or higher on the Atypical Energy-Related Symptom Scale). Youth with atypical depression were more likely to be female and reported higher rates of suicidal ideation (76.2%) compared with youth with non-atypical depression (48.1%). Additionally, those with atypical depression had experienced more traumatic events compared with those with non-atypical depression (median of two versus one, respectively) and were more likely to have made three or more lifetime suicide attempts (18.8% versus 12.5%, respectively).
The researchers found that those with atypical depression had higher depression severity across the six-month follow-up period. “These findings reinforce the persistent nature of atypical depression,” the authors noted, adding that “it makes sense to consider more targeted treatment strategies for this subtype in younger populations.”
Participants with atypical depression also had higher BMI and were more likely to be obese compared with those with non-atypical depression. “From a developmental perspective, it is important to assess whether individuals with atypical depression are at an increased risk of weight gain or metabolic issues due to the specific nature of their depression subtype or vice versa,” the authors wrote. “Understanding these dynamics can inform targeted interventions aimed at mitigating obesity-related health risks in this age group.”
For related information, see the Psychiatric News Special Report “Management of Major Depression—Yesterday, Today, and Tomorrow.”
(Image: Getty Images/iStock/Mixmike)
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