Examining Features of Atypical Depression in Youth From the Texas Youth Depression and Suicide Research Network Research Registry

Atypical depression has recently received attention as a subtype of depression marked by mood reactivity, increased appetite, hypersomnia, leaden paralysis and heightened sensitivity to interpersonal rejection, but research on the subtype has focused on adults. This study sought to determine the prevalence, sociodemographic and clinical correlates, and six-month trajectories of atypical depression in a youth sample. Within the study sample, 22.4% of TX-YDSRN youth had atypical depression, and these youth had greater baseline depression, anxiety, suicidality, and suicide attempts compared to those with non-atypical depression. Atypical depression was also associated with female sex, trauma history, obesity, and poorer physical functioning. Youth with atypical depression showed persistently higher depression severity across 6 months compared to youth with non-atypical depression, indicating that youth with the atypical subtype of depression face more severe clinical profiles which may warrant tailored clinical care.