Adults with atypical major depressive disorder (MDD) or double depression may be subgroups of the depressed population at particularly high risk of new-onset cardiovascular disease (CVD), according to a recent study. Thus, these subgroups may (a) be driving the overall depression–CVD relationship and (b) be in need of earlier and/or more intense CVD primary prevention efforts to reduce their excess CVD burden. Prospective data from 28,726 adults initially free of CVD who participated in Wave 1 (2001–2002) and Wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Researchers found:

• 1,116 incident CVD cases were identified.
• In demographics adjusted models, the atypical MDD group had a higher odd of incident CVD than the no depression history, dysthymic disorder only, and nonatypical MDD groups.
• Likewise, the double depression group had a higher odd of incident CVD than the no depression history, dysthymic disorder only, and MDD only groups.
• Relationships were similar but attenuated after adjustment for CVD risk factors and anxiety disorders.