Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
J Affect Disord. 2012 May;138(3):259-67. doi: 10.1016/j.jad.2012.01.042. Epub 2012 Feb 26.
Early onset depression (EOD) and late onset depression (LOD) may be different phenomena. In this study, differences between EOD and LOD in symptomatology, psychiatric characteristics and psychosocial/somatic factors were examined.
Baseline data were from 1104 participants with a current major depressive disorder participating in the Netherlands Study of Depression and Anxiety (age range 18-65 years). DSM-IV diagnoses, depressive symptoms and age of onset were assessed with the Composite International Diagnostic Interview. Analyses were performed by using a continuous as well as a dichotomous (cut-off 40 years) age of onset indicator.
Differences between EOD and LOD were observed: longer duration of symptoms (p<.001), a personal history of depressive episodes (p<.001), a serious suicide attempt (p<.001), childhood events (p<.001), a family history of depression (p=.03), and high neuroticism (p<.001) were more often present in EOD than in LOD. Also differences in symptomatology were observed: feelings of sadness (p<.001), diminished concentration (p=.02) and suicidal thoughts (p=.001) were significantly less prevalent at a higher age of onset, whereas decreased appetite/weight loss (p=.01) was more prominent at a higher age of onset.
The age of first depression onset was asked retrospectively and might be biased by selective recall. However, participants can likely recall whether symptoms started earlier or later in life.
Despite similarities, our observed differential findings in symptoms, psychiatric characteristics, and psychosocial factors between EOD and LOD further support that EOD is associated with more frequent occurrence of some clinical features of depression. These differential findings are important factors to keep in mind for diagnostics, treatment, and prevention.
早发性抑郁（EOD）和晚发性抑郁（LOD）可能是不同的现象。本研究旨在探讨 EOD 和 LOD 在症状、精神特征和心理社会/躯体因素方面的差异。
本研究的基线数据来自参加荷兰抑郁和焦虑研究的 1104 名当前患有重度抑郁症的患者（年龄范围为 18-65 岁）。使用复合国际诊断访谈评估 DSM-IV 诊断、抑郁症状和发病年龄。使用连续和二分（40 岁为界限）发病年龄指标进行分析。
EOD 和 LOD 之间存在差异：症状持续时间更长（p<.001）、个人抑郁发作史（p<.001）、严重自杀企图（p<.001）、儿童时期事件（p<.001）、家族抑郁史（p=.03）和高神经质（p<.001）在 EOD 中比在 LOD 中更为常见。此外，在症状方面也存在差异：EOD 中悲伤感（p<.001）、注意力不集中（p=.02）和自杀念头（p=.001）的发生率显著较低，而食欲减退/体重减轻（p=.01）在发病年龄较高时更为突出。
首次抑郁发作的年龄是回顾性询问的，可能存在选择性回忆的偏差。然而，参与者可能能够回忆起症状是在更早还是更晚的生命阶段开始的。
尽管存在相似之处，但我们观察到 EOD 和 LOD 在症状、精神特征和心理社会因素方面的差异发现进一步支持 EOD 与某些抑郁临床特征的更频繁发生有关。这些差异发现是诊断、治疗和预防时需要考虑的重要因素。
