Depression in later life: three etiologically different subgroups.
BACKGROUND
Various studies support the notion that early onset depression and late onset depression have different etiological pathways. Late onset depression has been found to be a heterogeneous group. This study attempts to divide the late onset group in two subgroups with different aetiology and find evidence for the vascular depression hypothesis.


METHODS
Subjects were 132 depressed elderly persons from the general population, general practitioners and mental health care outpatient clinics. Sixty-four had early-onset depression (< 60), 69 had late-onset depression (> or = 60). The latter group was divided into subjects with (n = 15) and without (n = 15) severe life stress. The groups were compared with respect to a variety of variables including vascular risk factors


RESULTS
Early-onset depression was associated with neuroticism and parental history. Subjects with late-onset depression and no severe life stress had higher vascular risk factors than whose depression was preceded by a severe stressor did.


CONCLUSIONS
Our findings suggest that late life depression can be divided into subgroups with different etiological pathways: (1) early-onset with longstanding psychobiological vulnerability; (2) late-onset as reaction to severe life stress; and (3) late-onset with vascular risk factors.
Van den Berg
M D
MD
Department of Social Psychiatry, University Hospital Groningen, The Netherlands. m.d.van.den.berg@med.rug.nl
Oldehinkel
A J
AJ
Bouhuys
A L
AL
Brilman
E I
EI
Beekman
A T
AT
Ormel
J
J
D000367:Age Factors; D000368:Aged; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000523:psychology; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors