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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)...



Clinical and aetiological heterogeneity have impeded our understanding of depression.


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


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).


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.


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

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Corresponding author

Femke Lamers, GGZ inGeest/Vumc, AJ Ernststraat 1187, Amsterdam, 1081 HL, The Netherlands. Email:


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The infrastructure for the NESDA study ( 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.



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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)...


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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)...
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