Irritability in depression may need to be treated differently

After languishing for years in the shadows of psychiatry's definition of adult depression, irritability is finally getting some respect again. It's about damned time, you might say.

A new study has found people suffering a major depressive episode who report they have become grouchy, hostile, grumpy, argumentative, foul-tempered, or angry will likely have a "more complex, chronic, and severe form" of major depressive disorder than those who do not acknowledge irritable feelings.

This isn't a small minority of the depressed: In this 30-year study of 536 subjects who first presented with depression, 54 percent acknowledged irritability in feelings and behavior. The current study found most women fell into its "irritable" group as well.

Compared with the merely sad, guilt-ridden, and lethargic, the irritable depressed had more severe depressive symptoms. They stayed depressed longer. They relapsed more readily, and were more likely to experience other psychiatric conditions. The difference between the two groups was so stark as to suggest major depression with "overt irritability/anger" might be treated as a distinct form, requiring more intensive care, the authors wrote. - Los Angeles Times