Analysis of Clinical Misdiagnosis of Atypical Depression

FAN Yi'nan; TAO Guifeng; SUN Dawei; PENG Longyan; LI Yue; JIANG Yuwei

doi:10.3969/j.issn.1002-3429.2025.06.002

Abstract：Objective To investigate the clinical characteristics of atypical depression,and to analyze the causes of misdiagnosis and countermeasures.Methods From June 2020 to June 2023,the clinical data of 10 patients with atypical de-pression who were initially diagnosed with other mental,psychological or physical diseases were retrospectively analyzed.Results Among the 10 patients,4 patients were misdiagnosed as chronic fatigue syndrome due to long-term fatigue and inat-tention.Three patients were misdiagnosed as bipolar disorder due to mood swings and irritability.Two patients with stomach discomfort as the main complaint were misdiagnosed as functional gastrointestinal disease.One patient was misdiagnosed as sleep disorder due to excessive sleep and sleep disturbance.After referral to the Department of Psychology,all patients were diagnosed with atypical depression through further examination.The duration of misdiagnosis was 1-3 months.After diagnosis,the patients received individualized symptomatic treatment,and the 6-month follow-up showed that the symptoms of 9 patients improved significantly,and 1 patient had no obvious relief in the early stage of treatment,but significantly improved after drug adjustment.Conclusion The clinical manifestations of atypical depression are complex and varied,which are easily confused with other mental and physical diseases.To improve the understanding of the characteristic symptoms,combined with stand-ardized psychological scale and multidisciplinary collaboration,is helpful to reduce the misdiagnosis rate and improve the diag-nostic accuracy.