Atypical depression (AD) is characterised by mood reactivity, interpersonal rejection sensitivity, hyperphagia, hypersomnia and/or leaden immobility (DSM-IV). Atypical features are reported in 15-30% of patients with major depression, and are associated with early onset, female gender, symptom severity/chronicity, functional impairment, self-injury, differential treatment responsiveness and specific comorbidities (e.g., cardiometabolic and substance/alcohol use disorders). The aetiology and mechanisms of AD are likely to be distinct from other depression subtypes, yet there has been insufficient research effort invested in identifying these differences and their implications for treatment.
Aims:
To elucidate aetiological and mechanistic aspects of AD and characterise associated neurocognitive, behavioural and physiological markers.
To evaluate the value of these markers for predicting outcomes and treatment optimisation.
Techniques/skills: Systematic review/meta-analysis techniques, advanced statistical modelling, experimental/cognitive psychological research design, psychophysiological measurement/analysis.
Objectives:
Year 1 – Comprehensive systematic review(s) on characteristics, epidemiology, aetiology and mechanisms in AD. Protocol development. Relevant training. Regulatory approvals to be obtained.
Year 2 – Secondary analyses of existing large-scale datasets (i.e., GLAD, UK-Biobank) to examine biological (e.g., genetic, neuroendocrine, immunological), behavioural (e.g., activity, socialisation) and psychological/social (e.g., personality, life events) features in AD, and their predictive relationships with key outcome domains (e.g., disability, quality of life, morbidity).
Year 3 – A cross-sectional laboratory-based study using experimental and psychophysiological methods to probe neurocognitive, affective, behavioural and physiological responsivity to relevant stimuli (e.g., social threat, reward) in AD compared to healthy controls and typical depression.
Year 4 – Data analysis, preparation of thesis and peer-reviewed journal articles.