Centre Ressource Régional de Psychiatrie du Sujet Agé (CRRPSA), Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris.
Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France; Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France.
J Affect Disord. 2022 Feb 15;299:585-595. doi: 10.1016/j.jad.2021.12.082. Epub 2021 Dec 22.
It remains unclear whether specific clinical factors contribute to heterogeneity in the timing of the onset of major depression.
Using a nationally representative US adult sample, the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions, we compared the characteristics of 5 different groups of patients defined by their age at onset: (i) before 18 years, (ii) between 18 and 34 years, (iii) between 35 and 44 years, (iv) between 45 and 59 years, and (v) 60 years or older. Specifically, we examined parental history of psychiatric disorders, history of childhood maltreatment experiences, sociodemographic characteristics, lifetime psychiatric disorders, and psychiatric disorders that occurred before the first major depressive episode (MDE).
Compared with first MDE occurring between 18 and 34 years, first MDE before 18 years was more strongly associated with childhood maltreatment and family history of psychiatric disorders, and less strongly linked to prior lifetime psychiatric disorders, whereas first MDE occurring at 60 years and older was more strongly associated with widowhood and a prior lifetime history of generalized anxiety disorder.
Associations found cannot be interpzreted as causal relationships due to study design and the risk of recall bias.
Our results suggest substantial age differences in risk factors for first MDE. Improving early detection and treatment of major depression and other psychiatric disorders, and preventing childhood maltreatment may have broad benefits to reduce the burden of MDE at all ages.
目前尚不清楚特定的临床因素是否会导致重度抑郁症发病时间的异质性。
我们使用具有全国代表性的美国成年人样本，即第二次国家酒精与相关情况流行病学调查，将发病年龄不同的 5 组患者的特征进行了比较：（i）18 岁之前，（ii）18-34 岁之间，（iii）35-44 岁之间，（iv）45-59 岁之间，以及（v）60 岁及以上。具体来说，我们研究了父母的精神病史、儿童期虐待经历史、社会人口统计学特征、终身精神病史以及首次重度抑郁症发作（MDE）之前发生的精神疾病。
与 18-34 岁之间发生的首次 MDE 相比，18 岁之前发生的首次 MDE 与儿童期虐待和精神疾病家族史的关系更为密切，与之前的终身精神病史的关系较弱，而 60 岁及以上发生的首次 MDE 与丧偶和之前的广泛性焦虑症病史的关系更为密切。
由于研究设计和回忆偏倚的风险，研究中发现的关联不能解释为因果关系。
我们的研究结果表明，首次 MDE 的风险因素存在明显的年龄差异。改善重度抑郁症和其他精神疾病的早期发现和治疗，以及预防儿童期虐待，可能会对减轻各年龄段 MDE 的负担产生广泛的好处。
