Mercer's Institute for Research on Ageing, St James's Hospital, Dublin 8, Ireland.
Int J Geriatr Psychiatry. 2010 Oct;25(10):981-7. doi: 10.1002/gps.2438.
It has been reported that late onset depression is more frequently associated with acquired organic pathology and that patients are less likely to report a family history of depression. Differences in phenomenology according to age of onset have been described although these have not been consistently replicated. The majority of these studies have been in hospital populations. The aim of this study is to address this question in a sample of community dwelling older adults.
89 subjects with GMS-AGECAT depression were identified from a sample of 1231 community dwelling adults aged 65 years and over. Subjects were analysed across a range of aetiological and phenomenological variables according to age of onset of first depressive episode.
Subjects with late onset depression (≥ 60) were significantly less likely to report a family history of depression, were less likely to report previous hospitalisation for depression and had greater cognitive impairment. Late onset subjects were also less likely to report feelings of guilt or thoughts that life was not worth living in the previous month.
While we found that patients with late onset depression differed from early onset patients according to certain aetiological risk factors, we did not find a distinctive profile of depressive symptomatology which might be considered clinically useful at an individual level. These findings are consistent with studies based in hospital populations.
据报道,迟发性抑郁症更常与后天获得的器质性病变有关,且患者更不可能报告家族抑郁病史。尽管已有研究描述了发病年龄不同的现象学差异,但这些差异并未得到一致证实。这些研究大多针对住院人群。本研究旨在针对社区居住的老年人群体来探讨这一问题。
从 1231 名年龄在 65 岁及以上的社区居住成年人中,通过 GMS-AGECAT 抑郁量表确定了 89 名有抑郁障碍的受试者。根据首发抑郁发作的年龄,对受试者进行了一系列病因学和现象学变量的分析。
发病年龄在 60 岁及以上的迟发性抑郁患者报告家族抑郁病史的可能性显著降低,报告既往因抑郁住院治疗的可能性也较低,认知障碍更为严重。迟发性抑郁患者在过去一个月中也较少报告内疚感或生活不值得过的想法。
虽然我们发现迟发性抑郁患者在某些病因风险因素上与早发性抑郁患者不同,但我们并未发现一种独特的抑郁症状谱,在个体层面上可能具有临床意义。这些发现与基于住院人群的研究结果一致。