title: Factors that differentiate early vs. later onset of major depression disorder.
abstract: This report explores the relationship between age of first onset of major depression and other demographic and clinical features in the first 1500 patients entering the Sequenced Treatment Alternative to Relieving Depression (STAR*D) study. Outpatients, 18-75 years of age, with nonpsychotic major depressive disorder (MDD) from either primary care or psychiatric practices constitute the population. Age of onset was defined at study intake by asking patients to estimate the age at which they experienced the onset of their first major depressive episode. This report divides the population in terms of pre-adult (before age 18) onset and adult (age 18 or later) onset. The results suggest that MDD that begins before age 18 has a distinct set of demographic (female gender) and clinical correlates (longer duration of illness; longer current episodes; more episodes; more suicidality; greater symptom severity; more psychiatric symptoms associated with Axis I comorbidity; and more sadness, irritability, agitation and atypical symptom features), and it appears associated with significant psychosocial consequences (lower educational attainment and marriage rates). Thus, pre-adulthood onset MDD is a particularly severe and chronic condition.
authors.affiliation: Department of Psychiatry, University of California, San Diego, San Diego VA Medical Center, 9500 Gilman Dr., 0603R, La Jolla, CA 92093, USA. szisook@ucsd.edu
authors.forename: Sidney
authors.initials: S
authors.lastname: Zisook
authors.forename: A John
authors.initials: AJ
authors.lastname: Rush
authors.forename: Ari
authors.initials: A
authors.lastname: Albala
authors.forename: Jonathan
authors.initials: J
authors.lastname: Alpert
authors.forename: G K
authors.initials: GK
authors.lastname: Balasubramani
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
authors.forename: Mustafa
authors.initials: M
authors.lastname: Husain
authors.forename: Harold
authors.initials: H
authors.lastname: Sackeim
authors.forename: Madhukar
authors.initials: M
authors.lastname: Trivedi
authors.forename: Stephen
authors.initials: S
authors.lastname: Wisniewski
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003710:Demography; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011584:Psychology; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D000928:Antidepressive Agents