Thompson Angus H
Department of Public Health, Flinders University, G3-FMC Flats, Bedford Park, SA 5042, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2008 Jul;43(7):538-44. doi: 10.1007/s00127-008-0329-x. Epub 2008 Mar 4.
Age of onset of major depression seems to be dropping in Western nations. Early onset usually predicts a more serious illness with a relatively poor prognosis. Since depression is associated with suicide, this begs the question of whether early onset of depression is associated with the degree of intent of suicidal behaviour, and whether this relationship differs according to gender.
Relevant responses from 9,282 residents of the United States were drawn from a nationally representative community survey conducted in 2001 through 2003 using the W.H.O. version of the Composite International Diagnostic Interview. The primary outcome measure was the retrospectively determined age of first major depressive episode.
Younger age of onset for depression was associated with higher levels of suicidal intent, irrespective of age at the time of interview. A significant interaction between level of intent and age at interview appeared to be accounted for by the later onset among those in the eldest cohort who reported an absence of suicidal behaviour. The influence of suicidal intent on onset of depression was greater for women than for men.
The earlier the age of first symptoms of major depressive episode, the higher the degree of suicidal intent, irrespective of age at interview and gender, although the more pronounced trend for women suggests a greater sensitivity to underlying factors that may involve depression and lead to suicide risk.
在西方国家，重度抑郁症的发病年龄似乎在下降。早发性通常预示着病情更严重，预后相对较差。由于抑郁症与自杀有关，这就引出了一个问题，即抑郁症的早发性是否与自杀行为的意图程度有关，以及这种关系是否因性别而异。
从2001年至2003年进行的一项具有全国代表性的社区调查中抽取了9282名美国居民的相关回答，该调查使用了世界卫生组织版的综合国际诊断访谈。主要结局指标是回顾性确定的首次重度抑郁发作的年龄。
抑郁症发病年龄越小，自杀意图水平越高，与访谈时的年龄无关。意图水平与访谈时年龄之间的显著交互作用似乎是由年龄最大队列中报告无自杀行为者发病较晚所导致。自杀意图对抑郁症发病的影响女性比男性更大。
重度抑郁发作的首发症状出现得越早，自杀意图程度越高，与访谈时的年龄和性别无关，尽管女性更明显的趋势表明对可能涉及抑郁症并导致自杀风险的潜在因素更为敏感。
