Department of Psychiatry and Behavioral Sciences, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA.
Int J Geriatr Psychiatry. 2012 Jun;27(6):601-11. doi: 10.1002/gps.2759. Epub 2011 Jul 19.
The aim of the study was to compare symptom expression in primarily middle-aged (<60) and older (60+) patients who were depressed and determine if symptom profiles differed by age.
Patients diagnosed with major depression (N = 664) were screened using the Center for Epidemiologic Studies--Depression scale and sections of the Diagnostic Interview Schedule. Patients were separated into homogeneous clusters based on symptom endorsement using latent class analysis.
Older patients were less likely to endorse crying spells, sadness, feeling fearful, being bothered, or feeling life a failure but were more likely to endorse poor appetite and loss of interest in sex. Older patients were also less likely to report enjoying life, feeling as good as others, feeling worthless, wanting to die, and thinking about suicide. In two latent class models with depressive symptoms as indicators, three-class models best fit the data. Profiles supported heterogeneity in symptom expression. Clusters differed by age when other demographic, clinical, health, and social variables were controlled but did not support age-specific symptom profiles. Overall, older patients had later age of onset, had fewer lifetime spells, were more likely to have ever received electroconvulsive therapy (ECT), and were less likely to have comorbid anxiety. Older patients also had more cognitive impairment, health conditions, and mobility limitations but had higher levels of subjective social support and had experienced fewer stressful life events.
There are age differences in symptom endorsement between younger/middle-aged and older patients with major depression. The data, however, did not identify a symptom profile unique to late-life depression.
本研究旨在比较原发性中老年（<60 岁）和老年（≥60 岁）抑郁症患者的症状表现，并确定症状特征是否存在年龄差异。
使用流行病学研究中心抑郁量表和诊断性访谈量表的部分内容对诊断为重度抑郁症的患者（N=664）进行筛查。使用潜在类别分析根据症状表现对患者进行分组。
老年患者更不容易出现大哭、悲伤、感到恐惧、烦躁或觉得生活失败等症状，但更可能出现食欲不振和性趣减退。老年患者也较少报告享受生活、感觉和他人一样好、觉得自己没有价值、想死和有自杀想法。在两个以抑郁症状为指标的潜在类别模型中，三类别模型最适合数据。各特征表明症状表现存在异质性。在控制其他人口统计学、临床、健康和社会变量后，各聚类在年龄上存在差异，但并不支持特定于老年的症状特征。总体而言，老年患者发病年龄较晚，发作次数较少，更有可能接受过电抽搐治疗（ECT），且合并焦虑症的可能性较低。老年患者还存在更多认知障碍、健康状况和行动限制，但主观社会支持程度更高，经历的生活压力事件更少。
在患有重度抑郁症的年轻/中年和老年患者中，症状表现存在年龄差异。然而，数据并未确定特定于老年期抑郁症的症状特征。
