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Age-Related Characteristics of Depression

A Preliminary STAR*D Report

Received December 1, 2004; revised January 21, 2005; accepted January 24, 2005. From the Dept. of Psychiatry, Univ. of Texas Southwestern Medical Center at Dallas (MMH, AJR, SMM, JH), the New York State Psychiatric Institute and the Dept. of Psychiatry (HAS), the Epidemiology Data Center, Graduate School of Public Health, Univ. of Pittsburgh (SRW, GKB), the Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA (NC), the Laureate Psychiatric Clinic and Hospital, Tulsa, OK (JRM, RH). Send correspondence and reprint requests to Mustafa M. Husain, M.D., Dept. of Psychiatry, Southwestern Medical School, 5323 Harry Hines Blvd., Dallas, TX 75390-8898. e-mail: mustafa.husain{at}utsouthwestern.edu
© 2005 American Association for Geriatric Psychiatry

Objective: Studies have shown that age is a determinant in the course of major depressive disorder. Age has been associated with depression severity; it has also been associated with varying depressive symptomatology. The authors explore the relationships between current age and depression severity, course of illness, presenting symptom features, and comorbid symptoms. Methods: Baseline clinical and sociodemographic information was collected on 1,498 participants enrolled in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study. Five age cohorts (18–25, 26–35, 36–50, 51–65, and 66–75) were compared on both sociodemographic and clinical factors. Depressive symptoms were measured with the 30-item clinician-rated Inventory of Depressive Symptomatology. Results: Clinically meaningful differences were found among age cohorts on several clinical and depressive symptom features. Older patients (51–65 and 66–75) endorsed longer durations of illness, more major depressive episodes, a later age at onset of their first major depressive episode, and more general medical comorbidities. Older patients had more middle and terminal insomnia, less irritability, and less hypersomnia. They were less likely to hold negative views of themselves or of their future and were less likely to report previous suicide attempts. Older patients were less likely to endorse symptoms consistent with generalized anxiety disorder, social phobia, panic disorder, and drug abuse. Conclusions: These cross-sectional data indicate that different age-cohorts present with varying sociodemographic and clinical characteristics, as well as general-medical and psychiatric comorbid conditions.

Key Words: Depression • Diagnosis • Symptoms • Comorbidity

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