Factors that differentiate early vs. later onset of major depression disorder

Zisook, Sidney; John Rush, A.; Albala, Ari; Alpert, Jonathan; Balasubramani, G.K.; Fava, Maurizio; Husain, Mustafa; Sackeim, Harold; Trivedi, Madhukar; Wisniewski, Stephen

doi:10.1016/j.psychres.2004.07.004

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Volume 129, Issue 2 , Pages 127-140, 15 December 2004

Factors that differentiate early vs. later onset of major depression disorder☆

Sidney Zisook
- Department of Psychiatry, University of California, San Diego, San Diego VA Medical Center, 9500 Gilman Dr., 0603R, La Jolla, CA 92093, USA
- Corresponding author: Tel.: +1 858 534 4040; fax: +1 858 822 0231.
A. John Rush
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
Ari Albala
- Department of Psychiatry, University of California, San Diego, San Diego VA Medical Center, 9500 Gilman Dr., 0603R, La Jolla, CA 92093, USA
Jonathan Alpert
- Department of Psychiatry, Harvard University, Massachusetts General Hospital, Boston, MA, USA
G.K. Balasubramani
- Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
Maurizio Fava
- Department of Psychiatry, Harvard University, Massachusetts General Hospital, Boston, MA, USA
Mustafa Husain
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
Harold Sackeim
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA
Madhukar Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
Stephen Wisniewski
- Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

Received 5 March 2004; received in revised form 23 June 2004; accepted 7 July 2004.

Abstract

This report explores the relationship between age of first onset of major depression and other demographic and clinical features in the first 1500 patients entering the Sequenced Treatment Alternative to Relieving Depression (STAR*D) study. Outpatients, 18–75 years of age, with nonpsychotic major depressive disorder (MDD) from either primary care or psychiatric practices constitute the population. Age of onset was defined at study intake by asking patients to estimate the age at which they experienced the onset of their first major depressive episode. This report divides the population in terms of pre-adult (before age 18) onset and adult (age 18 or later) onset. The results suggest that MDD that begins before age 18 has a distinct set of demographic (female gender) and clinical correlates (longer duration of illness; longer current episodes; more episodes; more suicidality; greater symptom severity; more psychiatric symptoms associated with Axis I comorbidity; and more sadness, irritability, agitation and atypical symptom features), and it appears associated with significant psychosocial consequences (lower educational attainment and marriage rates). Thus, pre-adulthood onset MDD is a particularly severe and chronic condition.

Keywords: Major depressive disorder (MDD), STAR*D, Age of onset, Gender, Antidepressants

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PII: S0165-1781(04)00189-1

doi:10.1016/j.psychres.2004.07.004

« Previous Next »Psychiatry Research
Volume 129, Issue 2 , Pages 127-140, 15 December 2004

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