Depressed Older Patients With the Atypical Features of Interpersonal Rejection Sensitivity and Reversed-Vegetative Symptoms are Similar to Younger Atypical Patients

Abstract

Objectives The atypical depression (AD) subtype has rarely been examined in older patients. However, younger AD patients have been characterized as having more severe and chronic symptoms of depression compared with non-AD patients. Design Secondary data analysis using ANOVAs and Growth Curve Modeling. Setting Clinical Research Center for the Study of Depression in Later Life. Participants Depressed older patients (N=248) followed over 2 years. Method In a longitudinal study, we examined depression severity and chronicity in patients with major depression with some features of atypical depression, specifically rejection sensitivity and reversed-vegetative symptoms (e.g., hyperphagia, hypersomnia), or leaden paralysis, and compared them to non-AD patients. The Diagnostic Interview Schedule (DIS) was used to assess depressive symptoms and history. Depression severity and chronicity were assessed every three months using the Montgomery Asberg Depression Rating Scale. Results The AD symptom group reported more DIS depressive symptoms, more thoughts about wanting to die, earlier age of onset, poorer social support and double the number of lifetime episodes than non-AD patients. Growth curve analyses revealed that, compared with non-AD patients, the AD symptom group had more residual symptoms of depression during the first year of follow-up, but not during the second year. Conclusion Characteristics of older patients with features of AD are similar to younger patients. Assessment of atypical symptoms, in particular rejection sensitivity and reversed-vegetative symptoms is essential, and should be considered in treatment plans.

Melancholia in later life: late and early onset differences in presentation, course, and dementia risk

“…Participants were then asked to identify the depressive symptoms present during that worst episode. The symptom list included items that would be characterized as "melancholic" (e.g., loss of appetite, weight loss, and excessive guilt) and those that would be characterized as "atypical" (e.g., increased appetite, weight gain, and increased sleep) (Sachs-Ericsson et al, 2012).…”

Six-year longitudinal course and outcomes of subtypes of depression

“…chronic course, duration index episode, number of episodes). [17][18][19][20][21][22] Only a few prospective studies have evaluated differences in course of depressive subtypes, with one study finding no difference in course between atypical and non-atypical depression, 23 another study finding an initial slower symptom severity recovery but similar severity end-points 24 and one study finding no difference in clinical outcome. 25 One study found the atypical subtype to be a predictor of obesity.…”

Relationship between mood disorders and functional decline in older adults during the COVID-19 pandemic

“…In some cases, they also refuse to eat, drink or use medication, and they may start having problems with self-care. [10][11]…”