Skip to main content
×
×
Home

Six-year longitudinal course and outcomes of subtypes of depression

  • F. Lamers (a1), A. T. F. Beekman (a1), A. M. van Hemert (a2), R. A. Schoevers (a3) and B. W. J. H. Penninx (a4)...
Abstract
Background

Clinical and aetiological heterogeneity have impeded our understanding of depression.

Aims

To evaluate differences in psychiatric and somatic course between people with depression subtypes that differed clinically (severity) and aetiologically (melancholic v. atypical).

Method

Data from baseline, 2-, 4- and 6-year follow-up of The Netherlands Study of Depression and Anxiety were used, and included 600 controls and 648 people with major depressive disorder (subtypes: severe melancholic n = 308; severe atypical n = 167; moderate n = 173, established using latent class analysis).

Results

Those with the moderate subtype had a significantly better psychiatric clinical course than the severe melancholic and atypical subtype groups. Suicidal thoughts and anxiety persisted longer in those with the melancholic subtype. The atypical subtype group continued to have the highest body mass index and highest prevalence of metabolic syndrome during follow-up, although differences between groups became less pronounced over time.

Conclusions

Course trajectories of depressive subtypes mostly ran parallel to each other, with baseline severity being the most important differentiator in course between groups.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Six-year longitudinal course and outcomes of subtypes of depression
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Six-year longitudinal course and outcomes of subtypes of depression
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Six-year longitudinal course and outcomes of subtypes of depression
      Available formats
      ×
Copyright
Corresponding author
Femke Lamers, GGZ inGeest/Vumc, AJ Ernststraat 1187, Amsterdam, 1081 HL, The Netherlands. Email: f.lamers@ggzingeest.nl
Footnotes
Hide All

The infrastructure for the NESDA study (www.nesda.nl) is funded through the Geestkracht programme of the Netherlands Organisation for Health Research and Development (ZonMW, grant number 10-000-1002) and is supported by participating universities and mental healthcare organisations (VU University Medical Center, GGZ inGeest, Arkin, Leiden University Medical Center, GGZ Rivierduinen, University Medical Center Groningen, Lentis, GGZ Friesland, GGZ Drenthe, IQ Healthcare, Netherlands Institute for Health Services Research (NIVEL) and Netherlands Institute of Mental Health and Addiction (Trimbos). F.L. is supported by a FP7-Marie Curie CIG (PCIG12-GA-2012-334065).

Declaration of interest

A.T.F.B. receives unrestricted grants from Eli Lilly, AstraZeneca, Jansen and Lundbeck.

Footnotes
References
Hide All
1 Antonijevic, IA. Depressive disorders – is it time to endorse different pathophysiologies? Psychoneuroendocrinology 2006; 31: 115.
2 Baumeister, H, Parker, G. Meta-review of depressive subtyping models. J Affect Disord 2012; 139: 126–40.
3 Penninx, BW, Milaneschi, Y, Lamers, F, Vogelzangs, N. Understanding the somatic consequences of depression: biological mechanisms and the role of depression symptom profile. BMC Med 2013; 11: 129.
4 Lamers, F, Vogelzangs, N, Merikangas, KR, de Jonge, P, Beekman, AT, Penninx, BW. Evidence for a differential role of HPA-axis function, inflammation and metabolic syndrome in melancholic versus atypical depression. Mol Psychiatry 2013; 18: 692–9.
5 Kendler, KS, Eaves, LJ, Walters, EE, Neale, MC, Heath, AC, Kessler, RC. The identification and validation of distinct depressive syndromes in a population-based sample of female twins. Arch Gen Psychiatry 1996; 53: 391–9.
6 Levitan, RD, Davis, C, Kaplan, AS, Arenovich, T, Phillips, DI, Ravindran, AV. Obesity comorbidity in unipolar major depressive disorder: refining the core phenotype. J Clin Psychiatry 2012; 73: 1119–24.
7 Cizza, G, Ronsaville, DS, Kleitz, H, Eskandari, F, Mistry, S, Torvik, S, et al. Clinical subtypes of depression are associated with specific metabolic parameters and circadian endocrine profiles in women: the Power Study. PLoS One 2012; 7: e28912.
8 Kaestner, F, Hettich, M, Peters, M, Sibrowski, W, Hetzel, G, Ponath, G, et al. Different activation patterns of proinflammatory cytokines in melancholic and non-melancholic major depression are associated with HPA axis activity. J Affect Disord 2005; 87: 305–11.
9 Hickman, RJ, Khambaty, T, Stewart, JC. C-reactive protein is elevated in atypical but not nonatypical depression: data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. J Behav Med 2014; 37: 621–9.
10 Rothermundt, M, Arolt, V, Peters, M, Gutbrodt, H, Fenker, J, Kersting, A, et al. Inflammatory markers in major depression and melancholia. J Affect Disord 2001; 63: 93102.
11 Anisman, H, Ravindran, AV, Griffiths, J, Merali, Z. Endocrine and cytokine correlates of major depression and dysthymia with typical or atypical features. Mol Psychiatry 1999; 4: 182–8.
12 Huang, TL, Lee, CT. T-helper 1/T-helper 2 cytokine imbalance and clinical phenotypes of acute-phase major depression. Psychiatry Clin Neurosci 2007; 61: 415–20.
13 Karlovic, D, Serretti, A, Vrkic, N, Martinac, M, Marcinko, D. Serum concentrations of CRP, IL-6, TNF-alpha and cortisol in major depressive disorder with melancholic or atypical features. Psychiatry Res 2012; 198: 7480.
14 Yoon, HK, Kim, YK, Lee, HJ, Kwon, DY, Kim, L. Role of cytokines in atypical depression. Nord J Psychiatry 2012; 66: 183–8.
15 Dunjic-Kostic, B, Ivkovic, M, Radonjic, NV, Petronijevic, ND, Pantovic, M, Damjanovic, A, et al. Melancholic and atypical major depression–connection between cytokines, psychopathology and treatment. Prog Neuropsychopharmacol Biol Psychiatry 2013; 43: 16.
16 Stetler, C, Miller, GE. Depression and hypothalamic-pituitary-adrenal activation: a quantitative summary of four decades of research. Psychosom Med 2011; 73: 114–26.
17 Lam, RW, Stewart, JN. The validity of atypical depression in DSM-IV. Compr Psychiatry 1996; 37: 375–83.
18 Stewart, JW, McGrath, PJ, Quitkin, FM, Klein, DF. DSM-IV depression with atypical features: is it valid? Neuropsychopharmacology 2009; 34: 2625–32.
19 Kendler, KS. The diagnostic validity of melancholic major depression in a population-based sample of female twins. Arch Gen Psychiatry 1997; 54: 299304.
20 Sun, N, Li, Y, Cai, Y, Chen, J, Shen, Y, Sun, J, et al. A comparison of melancholic and nonmelancholic recurrent major depression in Han Chinese women. Depress Anxiety 2012; 29: 49.
21 Gili, M, Roca, M, Armengol, S, Asensio, D, Garcia-Campayo, J, Parker, G. Clinical patterns and treatment outcome in patients with melancholic, atypical and non-melancholic depressions. PLoS One 2012; 7: e48200.
22 Khan, AY, Carrithers, J, Preskorn, SH, Lear, R, Wisniewski, SR, Rush, JA, et al. Clinical and demographic factors associated with DSM-IV melancholic depression. Ann Clin Psychiatry 2006; 18: 91–8.
23 Angst, J, Gamma, A, Sellaro, R, Zhang, H, Merikangas, K. Toward validation of atypical depression in the community: results of the Zurich cohort study. J Affect Disord 2002; 72: 125–38.
24 Sachs-Ericsson, N, Selby, E, Corsentino, E, Collins, N, Sawyer, K, Hames, J, et al. Depressed older patients with the atypical features of interpersonal rejection sensitivity and reversed-vegetative symptoms are similar to younger atypical patients. Am J Geriatr Psychiatry 2012; 20: 622–34.
25 Horwath, E, Johnson, J, Weissman, MM, Hornig, CD. The validity of major depression with atypical features based on a community study. J Affect Disord 1992; 26: 117–25.
26 Lasserre, AM, Glaus, J, Vandeleur, CL, Marques-Vidal, P, Vaucher, J, Bastardot, F, et al. Depression with atypical features and increase in obesity, body mass index, waist circumference, and fat mass: a prospective, population-based study. JAMA Psychiatry 2014; 71: 880–8.
27 Duggan, CF, Lee, AS, Murray, RM. Do different subtypes of hospitalized depressives have different long-term outcomes? Arch Gen Psychiatry 1991; 48: 308–12.
28 Parker, G, Hadzi-Pavlovic, D, Brodaty, H, Boyce, P, Mitchell, P, Wilhelm, K, et al. Predicting the course of melancholic and nonmelancholic depression. A naturalistic comparison study. J Nerv Ment Dis 1992; 180: 693702.
29 Melartin, T, Leskela, U, Rytsala, H, Sokero, P, Lestela-Mielonen, P, Isometsa, E. Co-morbidity and stability of melancholic features in DSM-IV major depressive disorder. Psychol Med 2004; 34: 1443–52.
30 Grunebaum, MF, Galfalvy, HC, Oquendo, MA, Burke, AK, Mann, JJ. Melancholia and the probability and lethality of suicide attempts. Br J Psychiatry 2004; 184: 534–5.
31 Lamers, F, de Jonge, P, Nolen, WA, Smit, JH, Zitman, FG, Beekman, AT, et al. Identifying depressive subtypes in a large cohort study: results from the Netherlands Study of Depression and Anxiety (NESDA). J Clin Psychiatry 2010; 71: 1582–9.
32 Lamers, F, Rhebergen, D, Merikangas, KR, de Jonge, P, Beekman, AT, Penninx, BW. Stability and transitions of depressive subtypes over a 2-year follow-up. Psychol Med 2012; 42: 2083–93.
33 Penninx, BWJH, Beekman, ATF, Smit, JH, Zitman, FG, Nolen, WA, Spinhoven, P, et al. The Netherlands Study of Depression and Anxiety (NESDA): rationale, objectives and methods. Int J Meth Psych Res 2008; 17: 121–40.
34 World Health Organization. Composite International Diagnostic Interview, Core version 2.1: Interviewer's Manual. WHO, 1997.
35 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). APA, 1994.
36 Rush, AJ, Gullion, CM, Basco, MR, Jarrett, RB, Trivedi, MH. The Inventory of Depressive Symptomatology (IDS): psychometric properties. Psychol Med 1996; 26: 477–86.
37 Lamers, F, Hoogendoorn, AW, Smit, JH, van, DR, Zitman, FG, Nolen, WA, et al. Sociodemographic and psychiatric determinants of attrition in the Netherlands Study of Depression and Anxiety (NESDA). Compr Psychiatry 2012; 53: 6370.
38 Hagenaars, JA, McCutcheon, AL. Applied Latent Class Analysis. Cambridge University Press, 2002.
39 Sullivan, PF, Kessler, RC, Kendler, KS. Latent class analysis of lifetime depressive symptoms in the national comorbidity survey. Am J Psychiatry 1998; 155: 1398–406.
40 Sullivan, PF, Prescott, CA, Kendler, KS. The subtypes of major depression in a twin registry. J Affect Disord 2002; 68: 273–84.
41 Rodgers, S, Ajdacic-Gross, V, Muller, M, Hengartner, MP, Grosse, HM, Angst, J, et al. The role of sex on stability and change of depression symptom subtypes over 20 years: a latent transition analysis. Eur Arch Psychiatry Clin Neurosci 2014; 264: 577–88.
42 Lamers, F, Burstein, M, He, JP, Avenevoli, S, Angst, J, Merikangas, KR. Structure of major depressive disorder in adolescents and adults in the US general population. Br J Psychiatry 2012; 201: 143–50.
43 Rush, AJ, Trivedi, MH, Ibrahim, HM, Carmody, TJ, Arnow, B, Klein, DN, et al. The 16-Item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry 2003; 54: 573–83.
44 Beck, AT, Epstein, N, Brown, G, Steer, RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56: 893–7.
45 Hirschfeld, RM, Williams, JB, Spitzer, RL, Calabrese, JR, Flynn, L, Keck, PE Jr, et al. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry 2000; 157: 1873–5.
46 Beck, AT, Kovacs, M, Weissman, A. Assessment of suicidal intention: the Scale for Suicide Ideation. J Consult Clin Psychol 1979; 47: 343–52.
47 Buist-Bouwman, MA, Ormel, J, De Graaf, R, Vilagut, G, Alonso, J, Van Sonderen, E, et al. Psychometric properties of the World Health Organization Disability Assessment Schedule used in the European Study of the Epidemiology of Mental Disorders. Int J Meth Psych Res 2008; 17: 185–97.
48 Grundy, SM, Cleeman, JI, Daniels, SR, Donato, KA, Eckel, RH, Franklin, BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735–52.
49 Rush, AJ, Weissenburger, JE. Melancholic symptom features and DSM-IV. Am J Psychiatry 1994; 151: 489–98.
50 Keller, MB, Lavori, PW, Mueller, TI, Endicott, J, Coryell, W, Hirschfeld, RM, et al. Time to recovery, chronicity, and levels of psychopathology in major depression. A 5-year prospective follow-up of 431 subjects. Arch Gen Psychiatry 1992; 49: 809–16.
51 Melartin, TK, Rytsala, HJ, Leskela, US, Lestela-Mielonen, PS, Sokero, TP, Isometsa, ET. Severity and comorbidity predict episode duration and recurrence of DSM-IV major depressive disorder. J Clin Psychiatry 2004; 65: 810–9.
52 Conradi, HJ, de Jonge, P, Ormel, J. Prediction of the three-year course of recurrent depression in primary care patients: different risk factors for different outcomes. J Affect Disord 2008; 105: 267–71.
53 Milaneschi, Y, Lamers, F, Mbarek, H, Hottenga, JJ, Boomsma, DI, Penninx, BW. The effect of FTO rs9939609 on major depression differs across MDD subtypes. Mol Psychiatry 2014; 19: 960–2.
54 van Loo, HM, de Jonge, P, Romeijn, JW, Kessler, RC, Schoevers, RA. Data-driven subtypes of major depressive disorder: a systematic review. BMC Med 2012; 10: 156.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×
Type Description Title
PDF
Supplementary materials

Lamers et al. supplementary material
Supplementary Material

 PDF (376 KB)
376 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Six-year longitudinal course and outcomes of subtypes of depression

  • F. Lamers (a1), A. T. F. Beekman (a1), A. M. van Hemert (a2), R. A. Schoevers (a3) and B. W. J. H. Penninx (a4)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *