Seasonality in atypical depression.

One definition of atypical depression has emphasized the reversed vegetative symptoms (hypersomnia and hyperphagia) (Aarons et al 1985) in the context of a nonendogenous (or mood reactive) depressive state (Ravaris et al 1980). This clinical picture overlaps with Seasonal Affective Disorder (SAD) (Rosenthal et ai 1984), which is a syndrome of recurrent depressions associated with fatigue, hypersomnia, hyperphagia, carbohydrate craving, weight gain, and interpersonal difficulties. Whether the two conditions are variants of a common underlying disorder is unclear although, based on the lack of response to phototherapy in eight atypical depressive patients, Stewart et al (1990) have suggested that atypical depression and SAD are separate disorders. A comparison of seasonality in several clinical populations and normals (Hardin et al 1991) showed that patients with SAD, subsyndromal SAD, and eating disorders had significantly higher seasonality scores than bipolar disorder, major depression (including a subset of atypical depressives), and normals. Clinically we noted that although atypical depressives may not meet specific criteria for SAD (especially the seasonal onset and remission), many of them exhibit a seasonal pattern of severity comparable to the SAD patients. In